Homoeopathic approach to Thrombosis

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Dr. B.D. Jatti Homoeopathic Medical College,
Hospital Post-Graduate Research Centre, Dharwad
Homoeopathic approach to Thrombosis Infarction

• By
• Dr. R. Y. Nadaf
• M.D(Hom.)
• Principal,
• Dr. B. D. Jatti Homoeopathic Medical College,
  Hospital Post-Graduate Research Centre,
  Dharwad

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Thrombosis
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• Formation of a blood clot (thrombus) in uninjured
  vasculature or thrombotic occlusion of a vessel
  after relatively minor injury. (Robins Cotrons
  Pathologic Basis of Disease 7th ed.)
• A condition in which blood changes from liquid to
  solid state and produces a blood clot. ( Oxford
  Concise Medical Dictionary 6 ed.)
• Thrombosis is the process of formation of solid
  mass in circulation from the constituents of
  flowing blood. ( Harsh Mohans Text Book of
  Pathology )

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• Haemostasis Thrombosis
• Normal homeostasis results from site of well
  regulated processes that maintain blood in fluid.
  Clot free state in normal vessels while inducing
  the rapid formation of a localized homoeostatic
  plug at the site of vascular injury.
• The Pathologic flip side to haemostasis is
  thrombosis.

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Normal Haemeostasis

• Three contributors to maintain normal haemostasis
• The vessel walls ( endothelial lining)
• The flow of blood.
• The constituents of blood (Platelets Clotting
  factors).

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Virchows Triad

• Three influences on Thrombogenesis
• Endothelial injury (atherosclerosis, vasculitis,
  trauma, radiation, bacterial toxins).
• Abnormal blood flow (turbulence in arteries e.g
  atherosclerotic plaque and stasis in the heart
  e.g dilatation and veins e.g abnormally dilated
  varicose veins, DVT).
• Hypercoagulability ( antithrombin III def,
  urinary excretion in nephrotic syndrome,
  procougulants secretion by tumour cells, tissue
  factors release after trauma, burns or delivery)

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Vessel wall defects (injuries)

• In heart and arterial circulation.
• Endocardial injury (example MI, Valvulitis)
• Over ulcerated plaques in the atherosclerotic
  arteries.
• Haemodynamic stress like hypertension, turbulent
  flow over the scarred valves, bacterial
  endotoxins.
• At the sites of the traumatic or inflammatory
  vascular injury.
• Hypercholesterolaemia.
• Radiation or products absorbed from the Cigar
  smoke.

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Changes in blood flow

• Turbulence
• Ulcerated atherosclerotic plaques not only expose
  subendothelial ECM, but also generate local
  turbulence.
• Stasis
• Abnormal aortic dilatations called aneurysms.
  Causes local stresses.
• M.I. Associated with endothelial injury and
• non-contractile myocardium.
• Mitral valve stenosis which causes left atrial
  dilatations which turns into arterial
  fibrillation exhibits stasis and thrombi
  formation.
• Hyperviscosity syndrome like polycythaemia which
  increases resistance to flow which causes small
  vessel stasis.

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Changes in the constituents of Blood, Platelets
Clotting Factors

• Hypercoagulability Uncommonest Poorly
  understood but alteration in coagulation pathway
  predispose to thrombosis.
• Primary or a genetic
• Mutations in factor V
• Antithrombin deficiency
• Fibrolysis defects
• Secondary
• Hypercoagulability seen with advancing age due to
  platelet aggregation which decreased PGI2
  released by endothelium. (PGI2 prostacyclin
  which inhibits platelet aggregation)
• smoking with obesity, oral contraceptives,
  glucocorticoid therapy.
• Autoimmune diseases like SLE
• Tissue injury - after surgery, Burns, Trauma,
  After infections (due to endotoxins.)

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Morphology

• Thrombi may develop anywhere in CVS, in Cardiac
  chamber, Valve cusps, or in Arteries, Veins,
  Capillaries and they are variable in size, and
  shape.
• Depending on the site of origin the
  circumstances which lead to their development.
• Arterial or cardiac thrombi occurs at the site of
  endothelium injury. (Atherosclerotic plaque or
  Turbulence).
• Venous thrombi begins at stasis.

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Morphology..

• Heart When thrombi arises from heart called
  Mural thrombi.
• Arterial Occlusive, Firmly adherent to vessel
  wall and Grey-white to Fragile, composed of
  Platelets, Fibrins, RBC and Leucocytes.
•  Venous Invariably Occlusive because they are
  Slow-moving in the vessel wall, they contain more
  RBC and called as a Red thrombi, seen in Hepatic
  vein and Portal vein.

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Fate of Thrombus

• Dissolution Removed by fibrolysis activity.
• Propagation increases the size and obstructing
  lumen.
• Organisation and Recanalisation May be organised
  in the vessel or recanalisation is formed.
• Embolisation May cause emboli.

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Homoeopathic Approach

• Bothrops and Lachesis have a special action in
  thrombosis. In varicose dilatations besides
  Pulsatilla, Thuja, Arsenicum, Clematis vitalba,
  Carbo vegetabilis and Calcarea fluorica, are of
  good use.
• Acetanilidum Thrombosis of the lower limbs from
  weak heart. Susceptible to colds, cyanosis and
  collapse. high blood pressure, faint, head feels
  enlarged, the breathing difficult, the heart weak
  and irregular, the feet and ankles swollen, the
  mucus membranes blue.
• Amm. Carb
• BLOOD VESSELS THROMBOSIS HEART CLOT,
  SUSPECTED, WITH PNEUMONIA.
• Hemorrhagic diathesis, from fluidity of blood
  and dissolution of red blood corpuscles tendency
  to gangrenous ulcerations.
• Erythema, then vesication finally gangrenous
  degeneration.

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Homoeopathic Approach.

• Apis
• THROMBOSIS of collateral veins, circuit
  unusually developed.
• Arg. Nit.
• Gastro-enteritis, and ulcer of the stomach, from
  thrombosis of its veins.
• Cactus G.
• The essential features of Cactus is heart
  conditions, Constrictive sensation about heart,
  the blood clots easily, the arteries and the
  heart contract excessively and painfully, the
  blood stream congests selectively on one organ or
  another (heart, vagina etc.), the heart
  palpitates violently.
• Benzoic acid
• Pains change place incessantly, but are most
  constant about heart.  
• Awakens after midnight with violent pulsations
  of heart and temporal arteries, 110 per minute
  internal but no external heat cannot go to
  sleep.  
• Gout, or rheumatism, affecting heart.  
• Hard, frequent pulse fever heat sweat

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Homoeopathic Approach.

• Bothrops.
• Yellow viper is most coagulating, therefore it
  is expected to be useful in thrombosis and
  thrombotic disorders as hemiplegia, aphasia
  inability to articulate.
• Amaurosis. Day-blindness, "can scarcely see her
  way after sunrise.
• Digitalis
• Violent but not very rapid beating of heart.
• Suddenly violent beating of heart, with
  disturbed rhythm a feeling of impending death,
  with terror and anxiety, slightest motion
  increases anxiety and palpitation.
• Thready, slow and intermittent pulse.
• Pulse very slow and weak.

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Homoeopathic Approach.

• Folliculinum
• Thrombosis caused by Contraceptive pills.
• Gunpowder
• Thrombosis of the veins with great oedema and
  prostration ensuing on the swallowing a quantity
  of pus from a dental abscess.
• Lachesis muta For thrombosis with high blood
  pressure.
• Nat. mur.
• Coldness round the heart in coronary artery
  thrombosis.
• Nat. sulph.
• Sycosis, hydraemia or leucaemia, thrombosis in
  hydrogenoid constitutions, particularly with
  affections of glands. Morbid ferments in blood,
  also in gonorrhea.

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Homoeopathic Approach.

• Petersons Bacillus 7
• THROMBOSIS of Central Retinal vein of Eye.
• Phos
• Hemiplegia, Facial and aphasic, from thrombosis
  of left middle cerebral artery.
• Quebracho aspidosperma Thrombosis of pulmonary
  artery.
• Secale
• Varicose ulcers and enlarged veins in old
  people. Neuralgia caused by pressure of distended
  veins. Varicosis. Thrombosis. Thrombosis of
  abdominal veins.
• Thrombus of the left femoral artery.

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Homoeopathic Approach.

• Vipera
• A common Eurasian poisonous snake, produces a
  venom that, in homeopathic doses, is a good
  remedy for thrombosis (formation of clots) in
  superficial veins, as well as for acute or
  chronic phlebitis (inflammation of a vein).
• The swelling in Vipera invariably leads to
  inflammation of the swollen area. This can be
  seen in a phlebitis or deep vein thrombosis in
  which the leg becomes red and feels hot and
  swollen. This can also be seen in Staphylococcal
  or Streptococcal skin infections which are red
  and abscessed. The skin forms pustules and
  eventually peels off.

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Infarction
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Infarction

• An infarct is a area of ischemic necrosis caused
  by occlusion of either the arterial supply or the
  venous drainage in a particular tissue.

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Etiology
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Types of infarction

• On the Basis of their colour
• Red or Hemorrhagic.
• White or Anaemic.
• On the presence or absence of microbial
  infection
• Septic (When infected)
• Bland (When free from infection)
• According to their age
• Recent or Fresh.
• Old or Heated.

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• Red infarct
• With venous occlusion eg. Ovarian torsion.
• In loose tissues eg. Lung
• In tissues with dual circulation. Eg. Lung
  Liver.
• In tissues that were previously congested because
  of sluggish venous out flow.
• White infarct
• With arterial occlusion.
• In solid organs
• Eg. Heart, Spleen Kidney.

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Pathogenesis
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Pathological Changes

• Grossly
• Infarct of solid organs are usually wedge shaped
  , the apex pointing towards the occluded artery
  and wide base on the surface of the organ.
• Recent infarcts are generally slightly elevated.
• Old infarct Shrunken and depressed.
• Infarcts in artery are pale.
• Infarcts in veins are hemorrhagic( Later most of
  infarcts become pale as red cells are lysed.

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Microscopic changes

• In all infarcts coagulative necrosis is seen
  except in cerebral infarction liquifactive
  necrosis occurs.
• At the periphery of infarct inflammatory reaction
  in noted. Initially nuetrophills predominate but
  subsequently macrophages and fibroblast appear.
• Eventually the necrotic area is replaced by
  fibrous scar tissue, which at times may show
  dystropic calcification.

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Factor that influence development of an infarct.

• The nature of vascular supply.
• The rate of development of the occlusion.
• The vulnerability of given tissue to hypoxia and
• Blood oxygen content.

Infarcts of different organs
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Remedies in General for Thrombosis Infarction

• Bothrops and Lachesis have a special action in
  thrombosis. In varicose dilatations besides
  Pulsatilla, Thuja, Arsenicum, Clematis vitalba,
  Carbo vegetabilis and Calcarea fluorica, are of
  good use.
• Acetanilidum Thrombosis of the lower limbs from
  weak heart. Susceptible to colds, cyanosis and
  collapse. high blood pressure, faint, head feels
  enlarged, the breathing difficult, the heart weak
  and irregular, the feet and ankles swollen, the
  mucus membranes blue.

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Remedies in General for Thrombosis Infarction..

• Amm. Carb
• BLOOD VESSELS THROMBOSIS HEART CLOT,
  SUSPECTED, WITH PNEUMONIA. Hemorrhagic diathesis,
  from fluidity of blood and dissolution of red
  blood corpuscles tendency to gangrenous
  ulcerations. Erythema, then vesication finally
  gangrenous degeneration.
• Arnica
• In painful thrombosis which occurs in the course
  of a vein after a phlebitis, where the least
  motion or exposure precipitates a fresh attack,
  Arnica given internally will cause the blood clot
  to be dispersed with surprising rapidity and at
  the same time counteract the tendency to relapse.
  Marked effect on the blood. Affects the venous
  system inducing stasis. Sore, lame, bruised
  feeling. Thrombosis.

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Remedies in General for Thrombosis Infarction..
Aurum Met Frequent attacks of anguish about
heart, with tremulous fearfulness great anguish
increasing to self-destruction, with spasmodic
contraction of abdomen uneasiness and hurried
desire for bodily and mental activity he cannot
do anything fast enough, and does not succeed in
satisfying himself is constantly impelled to be
in motion, and is sorry for his inactivity he
imagines he is neglecting something and deserves
reproaches in consequence. Violent heart-stroke
not synchronous with pulse. Benzoic acid Pains
change place incessantly, but are most constant
about heart. Palpitation agg at night, lying at
times tearing rheumatic pains in extremities,
relieving heart. Hard, frequent pulse fever
heat sweat.
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Remedies in General for Thrombosis Infarction..

• Cactus G.
• The essential features of course are the
  relationship to heart conditions, whether
  functional or severely pathological, and in
  particular to cardiac infarction and angina
  pectoris. The reason for this is that Cactus
  possesses in its pathogenesis the main
  characteristics of cardiac pathology. I have seen
  beneficial effects from the use of Cactus in
  cases of pulmonary oedema, myocardial infarction,
  and pericarditis, though additional remedies were
  necessary to complete the cure.
• The most predominant are 'constrictive sensation
  about heart, the blood clots easily, the arteries
  and the heart contract excessively and painfully,
  the blood stream congests selectively on one
  organ or another (heart, vagina etc.), the heart
  palpitates violently.

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Remedies in General for Thrombosis Infarction..
Med. Congenital heart disease, myocardial
infarcts, or heart attack at an early age
between forty and fifty is definitely early.
Family anamnesis history of sycosis suppressed
gonorrhoea (especially of the father or husband),
heart-diseases (angina pectoris, infarct),
arteriosclerosis, Down's syndrome, pernicious
anaemia,. China Infarctions of the liver, with
jaundice. Its great action is to cause debility
of the ganglionic nutritive fibres. Naja Cobra
venom (Naja tripudians) has been employed in
homoeopathy since the nineteenth century to treat
heart attack. 207 A recent publication mentions
the allopathic use of a cobra venom fraction to
treat myocardial infarction.
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Remedies in General for Thrombosis Infarction..
Syphilinum Cardiovascular syphilis attacks
principally the aorta, large vessels and heart.
Aneurysm of the ascending aorta can cause
pressure in the mediastinum and hoarseness, or
the patient may be symptom-free until death
results from rupture of the aneurysm, myocardial
failure or infarction. Congenital Syphilis.
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Thank you.