In the very similar condition of auricular flutter digitalis is useful for the same reason that it is efficacious for fibrillation, and fortunately the auricle can in these cases regain its normal action, and then the drug may be considered curative.
Impairment of conductivity in the auriculo-ventricular bundle may be brought about by diseases of those fibres, and may occur as the result of syphilis, rheumatism, diphtheria, influenza and other causes. In this case it is the normal impulse from the auricle that is hindered in its passage to the ventricle. The heart-beat rate is slowed. Some impulses do not get through, a beat is dropped, and the pulse intermits. Intermission may occur after every second, third or any other number of beats. In extreme cases the blockage is total, and then the ventricle provides its own stimulus, but with difficulty, and the pulse-rate is reduced to 40 or less. In bad cases of heart block the condition known as the Adams-Stokes syndrome may occur. The consists of sudden fainting or apoplectiform or epileptiform convulsions. It is caused by an unusually long pause between two pulsations, leaving the brain deprived of sufficient blood. An attack frequently proves fatal.
It is these states of heart block to which digitalis is homoeopathic, and must be given in the usual small doses, not lower than 2x, and in the potencies.
A very slow pulse is not necessarily due to diseases of the auriculo-ventricular bundle of His, thought it may be taken to be so if the heart beat is as low as 40 per minute; it may also be due to over-stimulation of the vagus, probably caused reflexly from the stomach or elsewhere, and will then be suitable for the homoeopathic administration of digitalis.
LEADING INDICATIONS.
(1) A very slow pulse.
(2) Pulse intermits every second, third or more beats.
(3) Feeling as if the heart would stop beating if the patient moves (gels., he must move).
(4) Great weakness and sudden sinking of strength.
(5) Jaundice, with nausea and vomiting and white stools.
(6) Faintness, as if dying, felt at the tip of the stomach.
(7) Blueness of the skin, cyanosis.
AGGRAVATION:
From movement, especially suddenly assuming the upright position, lying on the left side (palpitation).
AMELIORATION:
From perfect stillness.
Edwin Awdas Neatby founded the Missionary School of Homeopathy and the London Homeopathic Hospital in 1903, and run by the British Homeopathic Association. He died in East Grinstead, Sussex, on the 1st December 1933. Edwin Awdas Neatby wrote The place of operation in the treatment of uterine fibroids, Modern developments in medicine, Pleural effusions in children, Manual of Homoeo Therapeutics,