In repeating his medicine I told him that what benefit he had received from medicines was as much as he might expect until he abandoned the habit entirely.

If he did that he might hope to get perfectly well, and need not let the fact of there being heart-disease in the family cause him any concern.

He returned three days later, saying he had been very much better till the day before his visit, when he nearly fainted in the evening. I gave him Cactus I. He did not return again, so whether he made up his mind to abandon his habit or not I cannot say.

I am inclined to call these three cases instances of semi- functional disease of the heart. In all of them the heart was the seat and centre of the suffering. In none of them was any heart- lesion detected by physical examination, unless the slight muffling of the first sound in Case XXIX. may be counted such. And yet they were not purely functional cases. They differed from the cases of palpitation and breathlessness met with in hypochondriacal, hysterical and anaemic subjects, where the symptoms arise from no discoverable cause beyond the general condition of the patient. In each of them the heart-weakness was traced to the operation of a drug on the cardiac nerves or tissues or both.

Case XXVIII. and XXIX. present a striking likeness to each other. The same gnawing pain at the heart was complained of, the same kind of nervousness, the same giddiness and noises in the head, the same sleeplessness and constipation.

The same agent, alcohol, was at the root of each, and the same medicine-Spigelia-was in both strikingly beneficial. Case XXVIII. may be considered as an early stage of Case XXIX. S.P. was a younger man, and his indulgence had not lasted so long, consequently he was more speedily restored to health. J.B. was an older man, and an older toper, and his symptoms were, though the same in kind as S.P.’s, much more severe and long lasting. Palpitation, scarcely complained of by the one, was a very distressing feature in the case of the other. I am inclined to regard this, combined with the muffling of the first cardiac sound, as an indication that the structure of the heart had become somewhat degenerated in J.B.’s case. In Case XXVIII., if the disorder had passed beyond the limits of purely functional disease, the organic lesion was not so severe as to be beyond repair. In case XXIX. the tissue of the heart and probably the nerves as well, were degenerated, but the tissue that remained was still susceptible of being strengthened by proper remedies.

In the latter case I at first suspected an aneurism, and my failure to find any definite physical indication of one did not altogether allay my suspicions. I do not now, however, think that there was one present. The absence of any signs of hypertrophy or dilatation of the heart militates against the idea.

It is more than probable that the arteries were affected with atheroma in the early stage, but that cannot with certainty be diagnosed.

Case XXX., though closely resembling the other two cases, presented points of difference, as we should naturally except, arising as the disorder did from a different cause. All three patients, it is true, were addicted to the use both of alcohol and tobacco, but in two of them the former greatly preponderated, and in Case XXX. the latter. The characteristic features of this case were the continual faintness, sickness, and the dull pressure on the left side as if a substance were there-well known symptoms of tobacco poisoning.

When we meet with cases of this kind in young subjects without any history of previous carditis, we may be sure there is some cause at work. Simple fatty degeneration of the heart does not come on in early life without some definite cause. When we meet with symptoms that suggest it, as in the three cases related above, and find no traces of valvular mischief, or previous disease of the organ, we may at once set to work to find out the origin of the suffering. In the majority of cases we shall find it in the abuse of alcohol, or tobacco, or both. Sexual abuses of all kinds may cause it.

John Henry Clarke
John Henry Clarke MD (1853 – November 24, 1931 was a prominent English classical homeopath. Dr. Clarke was a busy practitioner. As a physician he not only had his own clinic in Piccadilly, London, but he also was a consultant at the London Homeopathic Hospital and researched into new remedies — nosodes. For many years, he was the editor of The Homeopathic World. He wrote many books, his best known were Dictionary of Practical Materia Medica and Repertory of Materia Medica