ANGINA PECTORIS.
LIKE every other organ and part of the body which contains nerves, the heart may be the seat of neuralgic pain. Heart pains may vary in intensity from something so slight that it hardly merits the name of pain to the intensest agony of the worst forms of Angina Pectoris or “Breast Pang.” This latter may occur in connection with actual organic disease of the heart and its vessels (instances of which have been already given), or it may be a pure neuralgia. In either form it may prove fatal in a paroxysm. A good many years ago I was called to make a post mortem examination of a man about 50 who had been found dead in the street in a doubled-up condition. I found the heart rigidly contracted and nothing else about him to account for death. The man had died of heart spasm. This was a case of pure Angina Pectoris, the muscle and vessels of the heart being healthy.
Compare with this the case of a gentleman who fell down whilst walking home across one of the parks. He was able to get up again and finish his walk, but had very much pain at the heart, and breathlessness, until he died ten days later. In this case there was extensive fatty degeneration of the heart wall and degeneration of the coronary arteries of the heart, which were almost occluded with the products of disease.
The disease which was revealed at the post mortem was quite sufficient to account for the heart failure; but it was of such a nature that no examination of the heart before death could have declared its presence, though the symptoms pointed to it. In case of this kind, as in many others, the symptoms are not only the safest but the only guide to diagnosis.
CASE XXXI.-ANGINA PECTORIS OF VACCINAL ORGAN. CURED BY Thuja.
Neuralgias of the heart do not arise (any more than other neuralgias) from nothing, even when there is no discoverable organic disease present. Nerve pains are symptoms of some defect of nutrition or the presence of some subtle poison, e.g., malarial or other fever poisons, or one or other of the chronic miasms of Hahnemann, or the poison of vaccinia.
The case I am now about to relate was one of the last class. The patient, a lady about middle life, had been vaccinated about a dozen times. She suffered from terrible attacks of neuralgia of head and face, more or less periodic, and at times from intense attacks of angina pectoris, generally coming on in the night, waking her out of sleep.
She received benefit from a number of remedies, but it was not until I realized the vaccinal origin of the malady and gave the patient Thuja in an exceedingly high potency that the attacks were got rid of altogether. A single dose of Thuja, after producing a severe aggravation, put an end to the attacks.
It required more than a single dose, however, to get rid of the vaccinal diathesis; for the same patient developed tumours in first one and then the other breast which caused her great alarm as she feared at first that they were cancerous. I strongly deprecated the idea of operation, and fortunately in this I was seconded by an allopathic doctor who saw the patient (she lived at the time in the country away from any homoeopath). Under medicines, and Thuja among the chief, the tumours disappeared and the patient regained a measure of health and strength to which she had been for many years a stranger.
Influenza has been responsible for many deaths from sudden heart failure with angina pectoris. I have seen a number of cases of angina caused by influenza, but happily they all recovered.
CASE XXXII.-INFLUENZAL ANGINA PECTORIS. REMARKABLE HEART’S- ACTION. RECOVERY.
A lady had suffered off and on for weeks from neuralgia of the left sciatic nerve, which yielded from time to time to various remedies, but never got well. Suddenly one day the pain vanished from the limb and she was struck with intense pain at the heart. Happening to be calling at the very time of the attack I found her in a most perilous condition. She was cold and livid. The pain, which was of a stitching kind, was so intense, that she dared not take a breath, and was gasping when I found her. The heart’s action was tumultuous and violent, with an extraordinary sharp clapping sound audible at several feet distant from the patient. She felt she was dying. I gave her a dose of Aconite 3 immediately, and repeated it every minute until she came round, which, happily, she did after one or two doses. But she did not altogether lose the pain, and for weeks was unable to lie on the left side on account of its causing the pain and the most alarming heart’s action. Aconite 3 was followed by Camphor (in pilules), and it was after the administration of Camphor that the true nature of the illness declared itself. The state of collapse was followed by symptoms of fever accompanied by intense pains in the back, so characteristic of influenza, and pains in both limbs.
The medicines had relieved the vital organ of the chief incidence of the influenza poison and driven it down to the lower limbs. There it gave an additional proof of its presence by producing an extravasation of blood near the right knee. Haemorrhage and extravasations of blood have been a very frequent manifestation of the influenza poisoning. With the pains there was the intense restlessness so characteristic of Rhus, and Rhus gave great relief. For the complete restoration of the heart to its normal state, many weeks of treatment were required. Carbo vegetabilis, Spigelia, and occasionally Camphor were the chief medicines given.
