This article first appeared in The American Homeopath, vol 19.
Cerebrovascular injuries, whether from trauma, surgery or internal chronic conditions, are all too often the cause of permanent disability, if not fatal outcomes. It is perhaps because of the very severity and hopelessness of these cases that they constitute some of the most frustrating and at the same time most rewarding work a homeopath can engage in. In this article I hope to convey some of the triumphs, as well as difficulties, we homeopaths may encounter while working with the victims of brain injury and their families.
Case # 1: Hemiplegia after Hemorrhagic Stroke with Hematoma
Harriet called from Roanoke, VA, about six hours from Durham, NC, where I then practiced. Her older sister Eleanor, aged 70, had collapsed after she suffered a hemorrhagic stroke and, “was now in a bad way.” She was lying in the hospital bed, nearly unconscious, and tests showed she was completely paralyzed on the left side. Her breathing was noisy, with a snoring sound. Eleanor was currently on a ventilator and taking several medications. Harriet, aged 62, was a retired hospital administrator and did not trust that conventional treatment was going to do her sister much good. She reasoned, “At the very least she can use all the help she can get!” The first few consultations were conducted with Harriet travelling six hours to Durham to speak with me in person. She would describe her sister’s appearance and observational symptoms, since Eleanor was unable to talk. She would then travel back the same day and take her the remedies, administering them herself.
May 5th, 1998
Harriet described Eleanor as “semi-conscious” and unable to speak. She did respond to questions by making sounds and shaking or nodding her head. She had developed pneumonia with a fever, and was on Keflex and three other medications. Eleanor had a bloated face that was dusky red and hot to touch. She was muttering and only occasionally responsive to attempts to talk to her. A left-sided paralysis was suspected since she was unable to move the fingers of her left hand or lift that arm and could not move her left leg, foot or even great toe. Stertorous breathing had begun before the pneumonia developed, and she now had rattling respiration deep in her lungs, as if drowning in her own phlegm. She was on a respirator.
Brain scans found that after the hemorrhage, blood had pooled and coagulated in one area on the right side of the brain. It was already several days after the stroke. It was important to get started with treatment as soon as possible. Medical records would be forthcoming.
In critical cases like this, taking the constitutional case can wait. A good acute clinical case and prompt treatment can start improvements and move the case quickly beyond the critical phase. Critical care is no time for orthodoxy. Aggressive homeopathic treatment (meaning: matching each syndrome to a remedy, dosing in alternation and repeating the doses frequently in the mildest of potencies, and clearing the effects of drugs and other obstacles to cure) can avoid the grave outcomes and serious long-term effects of cerebrovascular injuries. This approach rarely produces potentially dangerous aggravations in already compromised patients, which are commonly seen from high centesimal potency constitutional prescribing. 
The first remedy selected was Arnica montana, which covers stertorous breathing as a result of a stroke, along with a red-hot, bloated face. Arnica is associated with hemiplegia or paralysis and aggravations on the left side after stroke. I also selected Antimonium tartaricum to cover the pneumonia with rattling in the lungs as from copious phlegm. Since pneumonia is a separate condition, above and beyond the stroke, it most likely would need to be covered by a separate remedy, in this case Ant-t. These remedies were given in Q (LM) potencies, in standard dose and repetition.
In cases where several remedies are needed to cover the symptoms and/or more than one condition, alternation of several remedies has shown excellent clinical results. This method is consistent with Hahnemann’s practice during the last eight years of his life, as evidenced in his patient journals. Because of their special characteristics this is more advantageous in the Q-potencies since they can be repeated without adverse effects.
May 7th, 1998
A phone call from Harriet indicated there was considerable improvement in Eleanor’s breathing capacity. The amount of phlegm had reduced so considerably that the antibiotics would soon be discontinued. Eleanor seemed more alert; she no longer had a red face and “enjoyed being fanned.” I chose Carbo vegetabilis 30c, which Harriet obtained from a local health food store. She was to administer one dose in liquid and give it as needed afterwards, until things improved. She was to continue on Arnica in ascending Q potencies, one dose daily.
May 17th, 1998
Harriet reported in person this time. She had seen definite improvements. Eleanor had completely recovered from the pneumonia and was off the respirator and all antibiotics. She was fully conscious, but still unable to talk; however she responded well to questions by nodding or shaking her head. When she tried to talk or make sounds, “her voice sounds nasally and she seems dull, confused.” Her face still looked bloated and heavy. The left-sided paralysis was confirmed now that she was conscious. The plan was to continue Arnica, which covers this symptom.
June 8th, 1998
Harriet reported that Eleanor was “making good progress.” She was able to eat normally now. She was also able to talk, although she was having trouble articulating. She had made good progress in her ability to move her left side. She could lift her left arm and her leg, and could move her left foot and toes. Brain scans showed the hematoma had been almost completely reabsorbed. We would continue on Arnica montana.
June 29th, 1998
Harriet reported that a follow-up brain scan showed complete resolution of the hematoma. While there were some improvements in her speech and mobility, some problems remained: a left-sided hemiplegia and difficulty speaking. Now memory problems were becoming apparent, including some amnesia for events following the stroke. Eleanor continued to have a problem articulating her speech and some difficulty with comprehension. Harriet reported, “She seems to lose the sense of words and confuse numbers and dates.” Eleanor herself complained of feeling too hot all the time and still looked red-faced, bloated and dull. A red rash had appeared on her back that looked like sunburn. She was very sensitive to the slightest touch.
We were beyond the critical phase. Arnica had done much for her recovery so far, but a deeper acting remedy could move the healing process further along. To truly cure we needed to look at the underlying condition that had given rise to the present pathology and address it. It was time to learn more about Eleanor, her health history and her susceptibilities. I also needed to assess whether the current symptom picture was only the result of the stroke, or part of her existing susceptibility and constitution.
It turned out that she had a history of hypertension, obesity and always complained of being too hot. She craved carbohydrates. She loved coffee, pasta, oysters and alcoholic drinks. Harriet described her sister as often purple-faced. She had a bubbly personality, was energetic and outgoing socially. On more than one occasion she liked to drink a little too much wine, and was very “intense.” She was always worse in the morning on rising and was busy and talkative in the evening. She was single and had been a teacher but now she worked as an artist.
In situations like this, where you rely on descriptions by others, you must ask them to look for specific symptoms and ask specific questions. For example ask, “How do her eyes look?” “Can she move her eyes?” etc. To fully cover her pathological symptoms I considered remedies like Anacardium orientalis, Causticum, Lachesis mutus, Opium and Phosphorus—all of which have hemiplegia after stroke. Lachesis met the symptoms of the condition and her constitutional characteristics best, and was chosen in Q-potency in alternation with Arnica montana—just in case Arnica would continue to do some good work. I believed the rash was likely from the repeated diagnostic X-rays—radiation burn. X-ray in Q-potencies was to be alternated with the other two remedies. This would also serve to antidote the harmful effects of these scans and hopefully improve her overall health.
July 20th, 1998
Eleanor arrived at the consultation in Durham with her sister. She walked with a walker. There had been major progress in her mobility and her ability to speak was almost normal. I was now able to see that physically Eleanor was short and heavy-set. She now was able to report her own symptoms.
Her personality was optimistic and energetic. She told me she never felt she would not recover from this and it always felt like something temporary. She felt much improvement from the Arnica in the first three weeks, but then less so. Since the Lachesis she had seen dramatic improvement in her ability to talk and move. The two remedies together seemed to bring her a renewed sense of wellbeing.
Her biggest chronic symptoms had been hypersensitivity to touch and her constant general heat. Both have improved since Lachesis. In addition, she was lucid, quite different from reports of a few weeks ago. Her rash was much better. The X-ray was helping. She could feel a tingling in the rash on her back each time she took a dose. Some aching in the joints of the shoulder and hips had developed, so a reduction in her dose of X-ray was indicated. The other remedies were still helpful. I instructed her to dilute the liquid X-ray doses with three dosage cups and take it in alternation with Lachesis, both still once daily in ascending Q-potencies.
August 12th, 1998
Again, Eleanor came to my office with Harriet. She was now walking without difficulty. Her speech was back to normal. The hypersensitivity was no longer there. She no longer had any noticeable sequelae from the stroke. Even her rash was gone. She reported that for the first time she could remember she felt a little chilly. Considering that it was now August in the southern United States, this was a noteworthy symptom.
Her blood pressure averaged 138/78, which was significantly lower than before the stroke. She was currently taking the last of three potencies of Lachesis and had finished the two levels of X-ray. After taking a complete health history, family history and constitutional assessment, I chose Carcinosinum. Carcinosinum was a constitutional remedy to address a hereditary cancer diathesis. The cancer diathesis has hypertension. Carcinosinum would likely normalize it over the next few months. The instructions were daily doses of Carcinosinum in alternation with Lachesis in ascending Q-potencies, in standard repetition.
From now on, she continued with regular consultations every six weeks. There were no setbacks, only continued improvements in her overall health. Eleanor recovered completely from the stroke. She continued on the remedies Lachesis in alternation with Carcinosinum for six months.
Her file contains a thank-you note she sent after her last consultation, on January 7th, 1999, expressing her gratitude for her homeopathic treatment and recovery. She said she felt in much better physical shape than she had been in for decades. She was still well a year later when she called about her sister.
Harriet, who had faithfully brought Eleanor her remedies, was now in hospital in a coma. Could I help? Harriet had gone to the ER several days ago concerned about vertigo. An X-ray had showed a tumor in the brain. Immediate surgery was scheduled. The surgery found no tumor. Harriet felt well after waking up from the anesthesia, only to slip into a coma four hours later. She died before the homeopathic medicines arrived.
Case # 2: Coma and Hemiplegia after Brain Surgery
December 2nd, 1994
I received a call from Linda, a former student at The Homeopathic College. Michaela, a female African-American employee of hers, had been playing “catch” with Rachel, Michaela’s ten-year-old daughter. When Michaela slipped and lost her balance, Rachel fell and hit the back of her head against the wooden armrest of the couch. The girl seemed okay at first, but then Michaela noticed that she looked pale and disoriented. She immediately took her to the ER at Duke University Medical Center (DUMC), in Durham, NC, where Michaela was immediately arrested for “child abuse,” while Rachel was taken to have brain surgery for subarachnoid hemorrhage.
Rachel survived the surgery; however she slipped into a coma within the hour. Michaela, who was a single mother of two, had given Linda power of attorney and temporary custody so she could look after her child while she was awaiting trial. All of this had happened a week prior to her call. For the past week Linda had brought Rachel various remedies in medium to high centesimal potencies—Arnica montana, Carbo vegetabilis, and Strontium carbonicum—without effect. Linda was calling to see if I could help.
Linda met me at the hospital and introduced me to the attending physician who informed us that the girl has already been transferred to a facility for the care of comatose patients. However, he added, I could see her because I had permission from the legal guardian. Following his directions through a maze of long hallways and elevators, I found the girl in a darkened room, lying on a platform-like bed, attached to some electronic equipment and attended to by a nurse.
The nurse had been told to expect my visit, reminding me that her patient was in a coma and that she could not receive medication of any kind. I assured her I had no intention of giving her any medication. She repeated her reminder, as if she did not believe me. She added that Rachel could be in this state for weeks. Was she trying to discourage me? Then she left the room, shaking her head, to attend to her many other comatose patients. I have seen similar reactions of disbelief before on the part of medical personnel or even some family members when I was called into hopeless cases, where the staff or family member “knew” that nothing further could be done.
While my eyes adjusted to the dimmed lighting, I began to observe the girl looking for clues. She was lying on her back motionless and looked like she was sleeping, except for her half-open eyes. She was breathing calmly but more slowly than normal and apparently with some difficulty, as I could hear a regular snoring sound. Her pulse was full and slow. There was no response to touch. I looked closely at her eyes and could see that her pupils were contracted despite the dark room. Her face appeared darker than expected, taking into consideration her normal dark skin color. I talked to her; however, there was no reaction of any kind.
I returned to the office and called Linda. She was to pick up the remedy Opium 1Q, one pellet in water and apply a haptic dose to Rachel’s forehead, repeating once daily for up to ten days, succussing before each dose. Linda promised she would do her best.
December 7th, 1994
Linda called, overjoyed with good news. “Rachel is out of the coma! I gave her the dose on the forehead every day. After the first dose I saw a twitching of her toe. Today I was told she has been out of the coma for 24 hours and is responsive. However she has difficulty talking, she is drowsy, disoriented, and according to the neurologist, she is paralyzed on the whole left side.” The first two symptoms are to be expected after brain surgery and coma, and paralysis is not uncommon.
I was unable to see Rachel at the hospital, so I asked Linda to call me from there. Linda described Rachel making strange hand movements, as if she was picking at her bedcovers. She was able to make sounds but was unable to articulate, eat or even swallow. The remedy selected was Helleborus, in liquid Q-potency, sed daily, in the haptic dose, applied to her arm, since the nurses were very nervous about giving anything by mouth, in alternation with Arnica montana 1Q. When giving remedies in hospital it is a good idea to stick to the haptic or olfactory dose—either applying the liquid dose to the skin or holding the bottle under the nose to sniff it.
January 19th, 1995
The next remedy I selected was Lachesis 1Q in alternation with Arnica montana 2Q, in standard sed doses, with Arnica montana to be discontinued after a week. Arnica montana can sometimes work wonders in symptoms remaining after surgery; in this case it clearly did. After Arnica, Lachesis is clinically the most successful remedy in left-sided cases of hemiplegia resulting from brain hemorrhage. Linda gave the remedies to her—now in the olfactory dose, since the nurses felt comfortable with this route of administration.
I saw Rachel at the end of another ten days in her hospital room. She was now sitting up in bed and was able to eat and swallow with assistance. She was trying to talk. The attending physician was very happy with her progress. She was receiving speech therapy.
February 28th, 1995
Linda had been giving Rachel Lachesis 2-4Q, daily, ten days each. Rachel was able to use a pencil with her left hand. She was walking with a walker. She still had difficulty pronouncing words, but her overall progress in all areas was nothing short of phenomenal. I would see her again in six weeks.
Two weeks later she was transferred to rehabilitation. During the first month of rehabilitation she continued to improve, continuing on ascending Q-potencies of Lachesis. She had almost normal use of the left hand and leg. The last entry in my notes was based on Linda’s observations, “Walking well, still talking with difficulty.”
March 23rd, 1995
Linda reported that the court had ruled to give the state custody over Rachel, with visitation rights for Michaela after her release from incarceration. This meant Linda could no longer visit her. Michaela was sentenced to six months in a state penitentiary probation. This ended Linda’s temporary custody and Rachel’s homeopathic treatment.
Case # 3: Subarachnoid Hemorrhage after Head Injury
December 21st, 2004
Bill called at the urging of his wife Martha. Bill was 65 years old and a very active sailor. I had seen him on occasion for chronic treatment for several years. He just returned from the ER and needed an acute consultation. He had fallen off a ladder while refurbishing his boat and hit his head against the toolbox. After getting up he had noticed his back hurt, which was not a surprise since he had a chronic back problem. But what was disconcerting to him was a gurgling in the back of the throat and blood running from his nose and mouth. Looking in the mirror he fully expected a major gash on the side of his head where he had collided with the toolbox, but there was only a minor bruise.
He had asked his wife to take him to the ER. The physical exam and X-ray found a fractured rib, a punctured lung, a thoracic spine fracture, a possible facial bone fracture and a contusion at the left side of his head. By now he also had a major headache.
I selected Arnica montana, to match the injuries of the fall, including possible brain trauma. This was to be given in alternation with Bryonia alba, which covered pain worse from slightest motion, and Symphytum officinalis, which covered fractures of the rib and vertebra. All of these were to be taken in Q-potencies, a sed liquid dose every half hour, next higher potency after ten doses. We decreased the number of doses to standard protocol, or once per day, once he was stabilized. He was also told it might be beneficial to take vitamin C along with Echinacea angustifolia (HPUS) tincture for the first week, five drops twice daily, a measure that often helps prevent possible infection and improves healing from serious injury. As always, I strongly urged him to continue to have regular medical exams—something I did not have to convince him of this time!
January 26th, 2005
By now the full impact of the injury was evident. Bill had taken the remedies, and had also seen his doctor who gave him Percocet and Endocet for pain. There was a pain in his nose, extending into his left eye. His vision was okay. He complained of difficulty thinking and had noticeable trouble expressing himself. He had trouble articulating words, slurring his speech slightly. His head felt “strange” at times. He said it felt as if he had hit his head. However he did not have a headache any more, just a “strange” feeling. At first he had felt quite depressed, but this improved once he started taking pain medication. He was also taking Fioricet. In addition, he still had pain in his torso while sitting upright and while standing. This pain was better when lying down. He also felt a tingling in his left hand. There was a change in his voice and after being questioned he admitted he had noticed it, too. He seemed unusually slow to respond to questions. He complained of feeling drained, and a lack of energy. He seemed dull and confused and there were long pauses in his report.
While it is difficult to assess such symptoms over the phone, I had no doubt that he had suffered significant brain trauma. The doctor had scheduled a CT scan for the next week. I was familiar with this group of symptoms and what it could mean. I would not have been surprised if the scan found a hemorrhage or extravasation into the subdural or subarachnoid space, or worse.
It is interesting to note that Gelsemium sempervirens is the only remedy listed in the Complete Repertory under the rubric “subarachnoid hemorrhage”. Even though it had not been confirmed, there was no risk in giving a remedy to cover this eventuality. A careful repertorization of his symptoms yielded the remedy Lachesis. I selected both, to be alternated with Arnica montana and Symphytum officinalis. I also chose Hypericum perfoliatum, to address a possible spinal concussion. Hypericum perfoliatum has also proved very useful in cases of brain trauma. The instructions were the same: sed liquid doses of Q-potencies every half-hour in alternation, increasing potency after 10 doses of each level. Since he had discontinued Endocet and Percocet, I also chose Endocet and Percocet in 30c potencies, three doses per day, for three days, which is my standard protocol for antidoting the effects of drugs. This can be very important, as sometimes remedies do not act unless the system is freed from the lingering suppressive effects of these drugs. He was to let me know as soon as possible the results of the CT scan.
February 4th, 2005
Bill called in the early morning and seemed more alert. He ordered higher levels of his remedies, stating he felt much better. He felt he had almost completely recovered from his rib and back fracture. Although he still had a lot of pain, he continued to feel much better in general. He reported he still felt “weird in his head,” so he was going to have a brain scan later that day and would let me know the results right away. The same remedies were selected, including also several doses of X-ray 30c in liquid doses to be taken after the CT scan to clear the harmful effects of multiple X-rays.
Later the same day, Bill’s wife Martha called. She said the scan had found a subarachnoid hemorrhage and that surgery had been recommended. She had asked the surgeon if there were any risks and he had been wishy-washy, not denying risk but seemingly downplaying it. After she insisted, the surgeon suddenly said, “Yes, the risk is quite serious; this is a very serious condition, you could die from it. But it needs to be done. There is no other way.”
Martha herself had chronic lymphocytic leukemia and had been under homeopathic treatment for twelve years, avoiding chemotherapy, and with good results. Her confidence in homeopathy and in her practitioner was almost unlimited. She even said she would not support Bill if he chose to have the surgery.
February 6th, 2005
Bill called again for a consult. He did not bring up the idea of surgery, so I did not mention it either. But he did mention a laundry list of symptoms, some of which he had not reported previously.
He had begun to feel a mild to moderate sensation of pressure in his head, but no pain. He had trouble sleeping from discomfort in his rib and also from intermittent pain in the middle of his back. The pain appeared to be in the cartilage where the rib was attached to the spine and worse on the left side. This pain was mild to moderate while sitting upright in a chair, with a sensation of pressure on his spine, about ten inches below the shoulder blades. There was still tingling in his left hand. Turning to the left was painful. There was also pain from the right shoulder down into his right arm.
Bill had begun to wake at 2.30 a.m. feeling he needed to turn, but since it was painful to turn he sat up instead. While sitting, throbbing in his occiput would develop along with pain in the neck. The pain was better lying on a pillow. Apparently, this had been there since the accident but was getting progressively better.
He also had mild vertigo on exertion such as going up several flights of stairs. He once had trouble “seeing” things accompanied by blurred vision, lasting about 5-6 hours. It was, “as if I was unable to focus and then it went away.” He had no problem speaking and I noted that this was much improved; no more slurring of speech and normal articulation. Since the accident, he had bleeding gums with bright red blood.
Bill had seen a neurosurgeon at DUMC for a second opinion and this doctor wanted to do more scans. He was taking all remedies once daily now. Based on the progress and the symptoms, I saw no need to change remedies except to keep increasing the potencies after 10 doses of each Q-potency to the next higher level.
February 16th, 2005
Martha called to say that the DUMC surgeon confirmed the subarachnoid hemorrhage: the image showed a hematoma. He also recommended surgery. “He said there was no better way. Bill told him they [he and Martha] would keep him posted on their decision.” The next higher levels of remedies were ordered. He took another “round” of X-ray 30c clearing to antidote the CT scan.