Nervous - Chronic nerve damage

Cabrera, Chanchal

Medical Herbalism 07-31-95 9(2/3): 1, 4-6

Mr. E. first contacted me by letter in April 1992. He had heard me on a radio interview and wanted to know if I thought there was anything herbal that might help him with some chronic health problems. Because he was living several hours from the city I agreed to do a telephone consultation for him.

In November 1988 Mr. E. was involved in a car accident in which he was pitched headfirst through the windshield and into a brick wall ten feet ahead. He was taken to hospital suffering from loss of consciousness and unspecified cerebral damage. He was in a coma for five days and when he regained consciousness he was found to have global amnesia which lasted for two weeks. The major blow was to the right side of the head and he lost all sensation in the left leg and arm and left side of the body for a year following the accident. He also suffered from visual disturbances in both eyes — blurring of vision, transient scotoma [Ed: blind spot in visual field], and transient diplopia [Ed: double vision]).

At the time of our first consultation Mr. E. was still suffering from sporadic visual disturbances and episodic loss of memory (several times a week he would forget where he was or what he was doing and had got into the habit of always carrying a notebook with instructions for the day). He still suffered from some diminishment of sensation on the left side of the body as well as migrating leftsided parasthesias [Ed: tingling or other sensations moving across the skin], all of which were worsened if he drank alcohol or sat still very long. He had visual and auditory hallucinations, sensa especially if tired or under stress. He had temporomandibular joint misalignment and pain as well as a chronic pain in the right side of the head that was steady and constant. Other than this head pain, he did not suffer from headaches. He had right-sided tinnitus [Ed: ringing or other sounds in the ears] which was quite annoying although the hearing was not impaired. He had been irritable and aggressive since the accident and suffered from quite severe depression with suicidal tendencies. He had crepitus [Ed: popping sound of bones or cartilage] and reduced range of movement in the neck and a sensation of tightness in the throat that sometimes caused a subjective dysphagia [Ed: garbled speech, speech disturbance]. He had a lot of lower back pain with frequent spasms and `seizing’ of the lumbar area which would resolve only with strong analgesics (up to 6 Tylenol extra strength). He also had pain in the soles of the feet and regularly had night-time cramps in the calves. He felt cold a lot. Palpitations occurred daily, lasting up to 15 minutes and sometimes accompanied by sweating and\or dyspnea [Ed: shortness of breath]. There was a lot of belching and flatulence and bowel movements were loose and occurring four to six times daily. There was pain with pressure to the upper left abdominal quadrant. There were symptoms of prostatic enlargement with frequency of urination, difficulty starting and stopping the flow and a sensation of incomplete emptying. Sleep was poor with frequent waking due to pain. He felt chronically fatigued and this impacted on his work.
 
 
 

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Medical Herbalism: Clinical Articles and Case Studies

He was self-employed (the owner of a large holiday resort) and worked excessively long hours trying to build the business. He had lots of financial stress and his marriage was not completely happy. He had a two year-old daughter.

His diet was adequate with little red meat, no added sugar and no coffee. He ate a lot of dairy products, some junk food and drank alcohol daily.

Prescription:

Tincture (formula 1)

Harpagophytum procumb. (Devil’s Claw)        15 mls

Guaiacum off. (Guaiac)                     15 mls

Piscidia erythrina (Jamaican Dogwood)         20 mls

Ginkgo biloba (Ginkgo)                     15 mls

Hypericum perforatum (St Johnswort)             20 mls

Verbena off. (Vervain)                     15 mls

sig. 5 mls. tid. aq. cal. a.c.                100 mls

[5 milliliters three times a day in hot water before meals]

Rationale

Harpagophytum and Guaiacum are both well known as anti-inflammatory herbs for the joints. Guaiacum is an effective alterative as well helping to draw acid wastes away from areas of inflammation and to eliminate them from the body. Piscidia is included mostly for its anodyne properties, but it is also anti-inflammatory and anti-spasmodic in action. Ginkgo is used to encourage circulation to the head and enhance mental functioning and clarity. Hypericum is included as a regenerative and trophorestorative nerve tonic, to strengthen and heal the brain. Verbena is used as a relaxing nine with bitter properties causing it to be an energizing herb and a hepatic tonic. Both Verbena and Hypericum can also help with depression and irritability.

Tea

Mentha piperita (Peppermint)             25 g

Melissa off. (Lemon balm)             25 g

Chamomilla recutita (Chamomile)         25 g

Hypericum perforatum (St Johnswort)         25 g

                                100 g.
 

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sig. 1 tsp.: 1 cup water infusion tid. (three times a day)

Rationale

Mentha, Melissa and Chamomilla are all carminative digestive tonics and relaxants as well as aiding the Hypericum in relaxing the mind and alleviating stress.

Topical application

Infused offs of Symphytum off. radix (Comfrey root) and Phytolacca spp. (Poke root) with essential oils of Black pepper, Juniper, Marjoram and Rosemary over any sore or stiff areas.

Infused oil of Hypericum perforatum twice daily to the neck and down the left leg and arm.

Rationale

Phytolacca is alterative, stimulating and anti-inflammatory. Symphytum is soothing and healing. The essential oils are all rubefacient and counterirritant. Hypericum oil is anti-inflammatory and aids in the regeneration of nervous tissue.

Because the original injury was so long before and the damage so widespread, I was unsure as to whether the herbs would be effective so I offered to provide the formulations free of charge until such time as positive results were seen to occur.

A month after the initial telephone consultation I was able to see Mr. E in person. At that time he reported a slight reduction in the pain and parasthesias but no significant change in all other symptoms except a worsening of the digestive distress. A complete physical examination revealed normal bulk, tone and strength in all muscles with normal deep and superficial reflexes. Vibration sense and proprioception [Ed; ability to sense position and movement of the body] were diminished on the left side, suggesting some degree of damage to the spinal cord. Temperature, pain and pressure sensations were normal. All cranial nerve tests were normal. There was pain on palpation in the left upper quadrant area and fullness and dullness to percussion in the ascending and descending colon areas. There was moderate hepatomegaly [Ed: enlargement of liver]..

The digestive symptoms were consistent with a duodenalulcer and so the treatment was expanded to address this issue.

The initial formula was repeated: tincture, tea and topical application. As well the following tincture formula was prescribed:

Tincture (formula 2)

Glycyrrhiza glabra (Licorice)                 15 ml

Dioscorea villosa (Wild Yam)                 15 ml
 

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Althea off. radix (Marshmallow)                 20 ml

Geum urbanum (Avens)                     20 ml

Chamomilla recutita (Chamomile)             15 ml

Carduus marianus (Silybum marianum) (milk thistle)    15 ml

                                100 ml

sig. 5 mls. bid. aq. cal. a.c.

[5 milliliters twice a day in hot water before meals]

Rationale

Glycyrrhiza, Dioscorea and Althea are included for their soothing and anti-inflammatory demulcent effect in the upper digestive system which acts to reduce acidity and the sensitivity of nerve endings. Geum is used for its tannins which are astringent and so reduce inflammation as well as being antibacterial. Chamomilla is used to reduce stomach acid, as a carminative and to relax the nervous system. Carduus is included as a tonic and fortifier to the liver.

Ulmus fulvus (Slippery elm) lozenges to be sucked as needed, for their soothing demulcent effect.

Tincture (formula 3)

Piscidia erythrina (Jamaican dogwood)             20 ml

Chamomilla recutita (Chamomile)             20 ml

Passiflora incarnata (Passion flower)             20 ml

Scutalleria lateriflora (Scullcap)             20 ml

Valerian off. (Valerian)             20 ml

                        100 mls.

sig. 5 mls. p.r.n. aq. cal.

[5 milliliters as needed in hot water]
 

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Rationale

This combination of herbs has a strong anodyne action, relaxing the mind and easing the sensations of pain. The patient was encouraged to self-medicate only as needed.

Two months later Mr. E. reported complete resolution of the digestive discomfort. Bowel movements had reduced to two or three in the morning, gas was reduced, and the tightness in the throat had abated. He also reported a reduction in the pain and parasthesias on the left side and a general increase in energy and overall feeling of wellbeing. He still experienced occasional momentary blackouts and mental confusion. The sleep had improved considerably with the use of formula 3.

The formulations were simply repeated at this time with instructions to reduce the use of formula 2 to once a day.

Two months after this Mr. E. reported he was no longer suffering from hallucinations, visual disturbances, palpitations or dyspnoea. He still felt very stressed and fatigued although he was sleeping reasonably well and was feeling only occasional short-lived left-sided pain. There was still rightsided head pain but it was no longer constant and the tinnitus had diminished.

The herbal formulations were repeated at this time with instructions to take formula 2 only if needed.

3 months later Mr. E. reported that all symptoms had abated and he was feeling very much better. He was no longer having any blackouts and his memory and mental clarity had improved considerably. Left-sided parasthesias occurred only if he took alcohol and the pain was essentially gone. The head pain had reduced to a background level. The digestive discomfort occurred only if he missed a meal or ate very poorly. He still felt stressed but was dealing with it better because of the reduction in pain. All depression and suicidal feelings had cleared completely and he felt positive and optimistic about his future.

At this time Mr. E was told to continue taking formula 1 once a day for another couple of months but to use all other herbal products previously prescribed only as needed.

At the time of writing, almost eighteen months after commencing herbal treatment, Mr. E. remains virtually symptom free, providing he does not get overly tired, overly stressed or drink any alcohol. He has initiated several stress reduction techniques and has been receiving counselling, with his wife, for their marital difficulties.
 

Copyright 2001 Paul Bergner    295

Medical Herbalism: Clinical Articles and Case Studies

This case was particularly challenging because of the severity of the symptoms and their longstanding nature. The slow-acting, gentle herbs to nourish and support the nervous system with symptomatic treatment for the stress, poor sleep, pain and digestive problem was effective over a lengthy time frame. Mr. E. continues to receive herbal formulations occasionally which he uses only as needed. He has paid for the treatment with holiday-time at his resort which I consider to be a very fair exchange.

Commentary:

This case is typical of most medical cases in that it cannot be classified as a single problem. The head trauma and nerve damage, the digestive dysfunction, and the emotional problems were all interrelated. Restoration of normal digestion was essential to healing. I think the key herb in this case was hypericum, not only because of its antidepressant properties, but because of its ability to restore function to traumatized nerves. A key indication for its use in the last century was trauma to the spinal column and it was used, internally and externally at the same time, as in this case, for serious injuries. The hypericum oil should not be viewed simply as an external application, because the oils are readily absorbed through the skin.
 
 
 
 
 

Copyright 2001 Paul Bergner    296