Spotlight on Circulation

by Jenifer Worden

In order to understand what can go wrong in the circulatory system, it always helps to understand how it works. As a doctor, I have spent many years getting to grips with how a heart works and what veins and arteries are, and what they do, but I appreciate that what has become second nature to me might not be so to anyone else. I will, therefore, explain what circulation is, what can go wrong with it and, most importantly, how homeopathy can help. I will discuss three problems of the venous system (veins) and three problems of the arterial system (arteries). When discussing various problems and their homeopathic treatment, I most commonly would use a 6c or 12c strength remedy twice daily for physical symptoms only, for example varicose veins, and a 30c strength for a severe problem having both physical and mental symptoms like heart failure. This is, however, a rough guide only and for complex symptoms, I would always recommend that you seek advice from a professional medical homeopath

What is circulation?
The heart is basically a powerful bag of muscle, which by alternatively relaxing and contracting, acts as a pump. Each cycle of relaxation and contraction forms a single heartbeat, which we feel as our pulse. The blood circulating around the body and head comes through large nveins (vena cava) in to the right side of the heart. The right side of the heart is divided into an upper and a lower chamber (space) divided by a one-way valve. As the heart squeezes (contracts), the blood is pushed through this valve and out into the lungs via a blood vessel known as the pulmonary artery. The blood then passes through the lungs, where it absorbs oxygen from the air that we breathe in with every breath. The blood, full of oxygen now, returns to the left side of the heart via the pulmonary vein, into the upper chamber first and then into the lower chamber. It is finally squeezed out into the aorta, which is the large artery leading from the left side of the heart. The blood then passes around the body and head, releasing its valuable oxygen load, before returning via the vena cava to start the whole process all over again.

The reason why blood is so important is that oxygen is needed by every living tissue and cell in order for it to grow, repair and reproduce. Oxygen makes blood bright red. This is why blood taken in routine blood test at hospital or the GP surgery is a dark red colour as it comes from the veins (unless the nurse or doctor has made a mistake!) and so has little oxygen.

Arteries and veins
The arteries are like the big brothers of the circulatory family. They are strong and have relatively thick, muscular walls, which are hard to stretch but better at maintaining pressure. They are able to cope with fluctuations in pressure, caused by the alternate contraction and relaxation of the heart but if put under too much pressure, they will start to build up their muscular walls, rather like an athlete or body-builder does when muscles are asked to do extra work. This makes them harder to stretch and therefore increases the pressure within the arteries, which we measure as blood pressure.

The veins are the little brothers; they are thinner-walled with less or little muscle. They cannot hold pressure in the same way as the arteries. Linking the arteries to the veins are small arteries known as arterioles, which become smaller capillaries, which in turn join together to form the larger venules, which then form larger veins. By the time the blood is back into the veins, most of the blood pressure has dwindled away so the venous system is a low pressure one. In order to help the blood supply return to the heart from the lower half of our body, which means it must work against gravity, there are small one way valves in the veins of our legs; more about those later!

Right, so we have a pump with a network of veins and arteries keeping us healthy and alive, what can go wrong?

Varicose veins
These are very common and can be either be inherited from our parents or acquired. They are often regarded as a bit of a joke but to anyone who has them, they are not particularly funny. They give rise to troublesome symptoms such as tired, aching legs, swollen ankles and sore, hardened areas in the legs. Remember those one-way valves in the legs that I mentioned earlier? It is the gradual failure of those veins due to increased pressure on the venous system in the legs that leads to the blood not being pumped back to the heart so efficiently. This means that extra pressure is put on those simple valves, which sometimes give up the ghost completely and fail. When they do, they lead to the veins becoming stretched and contorted, which in turn gives rise to the familiar raised, knobbly varicose veins. Pregnancy, constipation and standing for long periods of time all put extra pressure on the veins in the pelvis, which in turn affects the lower leg veins. They can be associated with inflammation in the varicosities (phlebitis) or eczema around the lower calf and ankle (varicose eczema).

Conventional treatment relies on blocking the veins where the valve has failed and allowing undamaged veins in the area to take over. This can be done by injection or by physically “stripping out” the damaged veins surgically. However, there are several homeopathic options to try before the situation becomes too severe. Pulsatilla is a very commonly used remedy, due to its affinity for circulatory disorders; especially those associated with pregnancy. This does not mean that male members of the population cannot use it! Reasons to choose Pulsatilla for the treatment of varicose veins include the symptoms being all right one day but not the next. People who do well with Pulsatilla often tend to be mild-mannered, avoiding arguments if they can, but these are generalisations and are only meant as a guide when treating very physical symptoms, such as varicose veins.

My second choice of homeopathic remedy for varicose veins would be Calc carb. Whereas Pulsatilla tends to suit people who are generally warm-blooded and prefer to have fresh air in their homes, those requiring Calc carb are definitely chilly, with markedly sweaty feet. They hate damp conditions or damp weather but, like those needing Pulsatilla, tend to be mild in manner, perhaps verging more to the shy side or slightly nervous.

Another useful remedy, related to Calc carb is Calc fluor. This is particularly useful where there are hardened, knotty varicosities of the veins, especially after phlebitis. An almost specific remedy for varicose veins and piles is Hamamelis. Sulphur can be used when there is ulceration and irritation of the varicosities, such as in phlebitis or varicose eczema. One of the key symptoms for choosing Sulphur is “must scratch until it bleeds”.

Piles
The technical term is haemorrhoids. The term pile is often used for both true of the anus, and false piles, which are usually skin tags or polyps of the anal and rectal tissue. (Doctors don’t help as we also use the term interchangeably but the treatment is quite different.) Haemorrhoids are caused by the same problems that cause varicose veins; pregnancy and constipation. However, if the circulation is sluggish, such as if the heart is not working effectively, this can also result in haemorrhoids.

Haemorrhoids can be internal or external. Internal haemorrhoids stay inside the rectum and cause discomfort and bleeding on having the bowels open.  External haemorrhoids drop down and cause pain, bleeding and difficulty in opening the bowels. Skin tags become inflamed and itchy. Occasionally, external haemorrhoids can bleed into themselves and cause a small blood clot that is surprisingly painful, given the size of the problem. A simple drainage operation by your GP or surgeon can sort this latter problem out and Arnica is very helpful when taken afterwards.

Homeopathically, Hamamelis, Calc fluor and Arnica are excellent for haemorrhoids and some of the commercial homeopathic haemorrhoid creams have a mixture of these remedies within them. If the skin of the anus has become cracked, giving rise to the symptoms of violent cutting pains after opening the bowels lasting for hours, Nitric ac can be a real help. Such symptoms often are given the diagnosis of an “anal fissure”. Haemorrhoids associated with marked constipation with the desire to open the bowels but with little effect when one tries, particularly in a stressed person (typically the “uptight executive”) do well with Nux vomica.

Cold hands and feet
Being a sufferer myself, I know only too well how painful this can be. Sneaking in to bed with socks on may not be very glamorous but is exceedingly practical. Cold hands and feet can be due to your particular metabolism (“lack of vital heat” in homeopathic terms) or can be due to failings in the arteries, veins or lungs. A particular problem, known as Raynaud’s disease, affects predominantly women and has no known cause. It usually affects both hands and is made worse by cold weather. Affected fingers go through a set pattern of colour change: white, blue then red. This is due to changes in the small blood vessels in the fingers, constriction followed by slowing of the blood supply and then dilation. If it is due to an illness such as sclerosis or diseases of the arteries that cause narrowing, the symptoms are known as Raynaud’s phenomenon. This can also affect pneumatic drill users when it is known as “vibration finger”.

Remedies to help include Calc carb and this is also indicated when one suffers from cold feet at night. Cuprum can help when the soles are burning but the rest of the foot feels cold. Sulphur is very useful when people suffer from the sensation of cold feet but the skin is warm to the touch, Phosphorus when the hands feel cold but are actually warm. Blue hands and feet do well with Carbo veg and if the person is older, then Baryta carb can be used for the same symptoms. Several of the homeopathic remedies deriving from snake venom are used for circulatory problems. This relates to the fact that the effect of venom from the bushmaster snake (Lachesis), rattlesnake (Crotalus) and cobra (Elaps) is to cause swelling and paralysis with pooling of the blood in affected areas. In homeopathy, use of a substance that causes symptoms similar to those that one is trying to cure is the basis of the “like cures like” principle.

Hypertension
High blood pressure, hypertension, affects over 16 million people in the UK and is a major cause of strokes. Ninety per cent of cases are “idiopathic” – no known cause. Common risk factors, or things that put you at risk of developing high blood pressure include smoking, being overweight and inactivity as well as other diseases such as heart disease (for example, blocked arteries due to cholesterol or arteriosclerosis) or diabetes. By reducing your blood pressure, you can vastly reduce the risk of having a stroke. It is possible to make a full recovery from circulatory problems such as a heart attack caused by a blood clot in the arteries supplying the heart itself but a stroke can often leave life-changing residual disability. Eating healthily, taking regular exercise and not smoking can make a huge difference to your health. If your blood pressure is raised, it is always wise to seek medical advice from your GP, practice nurse or hospital doctor.

Contrary to popular belief, high blood pressure has very few symptoms and is usually found by accident when seeing the doctor for an unrelated problem or as part of a routine medical. Because of this, it can be difficult to treat homeopathically but a well-chosen constitutional remedy selected on the basis of your personality, likes, dislikes and general symptoms such as temperature preferences can help, particularly when taken alongside conventional medication. I am a firm believer in using conventional medication if symptoms cannot be controlled solely using homeopathic remedies and often lower doses than expected of conventional medicines can be used alongside a well-chosen homeopathic remedy.

Natrum mur is a good baseline remedy to try for hypertension, as it is based on sea salt and the link between excessive levels of salt in the diet and raised blood pressure are well recognised. People doing well with this remedy often bottle things up, being good listeners but perhaps not being so able to talk about themselves. They are sensitive but find it difficult to cry in front of people who are not close relatives.

A common side effect of the group of allopathic medications known as ACE inhibitors is that of a dry, irritating cough. These medications are used to treat hypertension and other heart problems. Although the medication can be changed, the cough can take some time to settle. I discovered by relative accident that Conium, with the prominent symptom of “cough, with expectoration only after long coughing”, can be an excellent remedy for this problem, taken at 30c strength daily until the cough is relieved.

Angina
This is simply cramp in the heart muscle and can be due either to spasm of the coronary arteries (those supplying blood to the heart itself) or to poor blood supply due to narrowing of the arteries due to arteriosclerosis. If there is a complete blockage of the blood supply, leading to damaged heart muscle, then this is a step on from angina and is a heart attack (myocardial infarction). Prevention of raised cholesterol levels, and therefore prevention of arteriosclerosis, is very important. The fitter the heart, the fitter the body. Diet can help but most of us make too much cholesterol as well as taking it in our diet so it may be that conventional medication is needed in order for it to be lowered enough not to be a danger to health.

The predominant symptom of angina is a feeling of pressure in the chest, “like an elephant”, and the homeopathic remedies for angina often reflect this sensation of tightness in the chest. Angina is most commonly felt as constriction in the central chest area but can also give rise to pain in the neck or jaw or an aching sensation in the left arm. Cactus is probably one of the best well-known angina remedies with its hallmark symptom of “constriction … as if of an iron band” when referring to chest pain. It also has the key symptoms of “palpitation shooting down the left arm”. It is the remedy that I tend to start with first, usually alongside conventional medication. If Cactus leads to no improvement in symptoms, then Glonoine can help. Glonoine is related to glyceryl trinitrate (GTN), which is used as a very effective orthodox treatment for angina, being taken either as a spray in the mouth, or as a small tablet dissolved under the tongue.

Heart failure
This is a common condition with a somewhat frightening title. The medical profession has looked at many different names to give to the collection of symptoms that result from the heart not working effectively but no real alternative has yet been found. It is the heart working inefficiently as a pump which leads to poor oxygenation of the blood (causing breathlessness and tiredness) and sluggish circulation (leading to fluid collecting in the lungs and/or legs). In old-fashioned terms, this is dropsy. Fortunately nowadays, there are many conventional medications to reduce or remove these distressing symptoms. To minimise their use, or to help them work more effectively, there are a variety of homeopathic remedies to take. Cactus has already been mentioned with the addition of the symptoms “fear of death”, “heart weakness of atherosclerosis” and “ice cold hands”, all commonly found in people suffering from heart failure. Crataegus, hawthorn, has been used as a remedy for hundreds of years, being noted in Culpepper’s Herbal as an “invaluable treatment for dropsy”. It can be used homeopathically either in tincture form or in potency.

Jenifer Worden MBChB MRCGP MFHom is a part-time NHS GP in a semi-rural general practice in Ringwood, Hampshire and also has her own private practice in homeopathy and acupuncture in Highcliffe, Dorset.