I NOW come to the last and most important means we possess of counteracting diseases of the heart, or, for that matter, diseases of any kind-I mean the powers of medicines. The popular belief in the power of drugs to cure sick people is ineradicable; and all the efforts of a sceptical Medical Faculty to prove that drugs cannot “cure,” and that all the Faculty can do is to “treat” patients, has had no other effect than to cause the lay mind to look to those who have something more encouraging to offer. The popular belief is well founded: the scepticism of th Faculty is the result of a one-sided education which has had the effect of closing its mental vision to all the possibilities that are not dreamed of in the philosophy of the schools.
That drugs will cure has been proved over and over again by millions of experiences, some accidental, some under the guidance of science. The point to be remembered is that drugs do not cure diseases, but patients. I am sometimes asked “Is there any cure for cancer?” To which I reply “There is no drug which will cure everybody’s cancer; but many cases of cancer have been cured by one or more drugs. Every patient must be treated according to the characteristic features of his particular case, and it is just here that the science and art of medicine come in.”
The reason why nearly all the new “cures” that are introduced into old school practice vanish from the old school armamentarium after a very brief career, is not that they are of no curative value, but because those who introduce them regard them as “specifics” for certain “diseases” and have no idea of defining the precise indications for their use. By some lucky chance the first series of patients on whom they try the drug happen to present the proper indications for its use-their cases are in homoeopathic relationship to it, in short,-and they are cured. The allopath knows nothing about this and proceeds to give the same drug to a number of other patients who have the disease called by the same name as that the first patients had, but not presenting the same characteristic indications, and the drug fails to do good. Henceforth it is thrown aside as “unreliable” or “useless,” until some despised homoeopathist takes it up and “proves” it, thus finding out what are its characteristic symptoms. Thenceforth it takes its place in the homoeopathic Materia Medica as a valued and trusted implement of the art and science of Healing.
What is curative action? Disease, according to the Hahnemannic conception (and I have not yet found a better), is a dynamic or spirit-like change in the left principle of the organism or of any particular organ or tissue.
When the animating principle is in any way hurt, nutrition is not properly carried on. The microscopic elements of the tissues do not undergo their proper transformations, and the whole organ or the whole body is enfeebled. Unless some new agency is brought to bear on the suffering organism, the tendency is for the disease-action to progress from bad to worse. It is here that the specific medication of Hahnemann steps in, and by neutralising the dynamic change in the life-principle, brings back proper nutrition. Then the feeling of well-being and strength comes back. The amount of repair possible depends in each case on the degree to which the degenerative change has gone in the first instance. Where the tissue elements have been destroyed they cannot be restored; but no one can tell in any case how many elements of undeveloped tissue may lie dormant in a damaged organ, ready to be called into life by proper remedial measures, so that it is always the right course to pursue to aim at cure.
The same explanation applies in the case of the cure of tumours. The vital principle, through some change in its operation, produces instead of normal tissues, tissues more lowly organised, with a different life-history from that of the tissues from which they spring. The nutritional changes are different from those of surrounding tissues, and the appearance of new growths or tumours is the result.
But the agency which produce tumours can also remove them, if only the proper specific medicines are administered by which the perverted action will be reversed.
Much of the disputing that has taken place over the proper method of selecting specifics might have been avoided if only the disputants has perceived that in adjusting the sights different focuses may be made use of. One practitioner, for instance, will use the fine adjustment, taking a minute observation of the symptoms of a patient in great detail and will find a simillimum to cover the picture. Another, working with a lower power, will take a more general view of the case, and select a medicine which he thinks corresponds to this. Both methods have given admirable results, and both have their place in homoeopathy; and it is not at all my intention to dogmatize as to which is the better plan. I have succeeded with each one where the other has failed me.
It has been very truly said that any medicine may be required in any disease, and the case I have recorded in which Crocus played such a brilliant part is an illustration in point. If therefore I am asked,”What medicines are good in cases of heart disease?” I must reply,”All the medicines in the Materia Medica.”
At the same time it is a very useful work to single out those medicines which have such characteristic action on the heart that they reproduce the features of the majority of the cases met with, and this I now propose to do. It must always be borne in mind, however, that for successful practice it is necessary to take into consideration the whole of a patient’s symptoms, more especially the characteristic mental and moral symptoms, in selecting a medicine, and unless the correspondence is good all round only a partial result must be looked for.
The following list may be taken as the selection I should make for my own use if I were limited to a definite number of drugs. Aconite, Ammonium carbonicum, Apocynum, Arnica, Arsenicum album, Arsenicum iodatum, Aurum, Baryta carbonica, Baryta muriatica, Belladonna, Bryonia, Cactus, Calcarea carbonica, Camphora, Carbo animalis, Carbo vegetabilis, Causticum, Cimicifuga, Coffea, Crocus, Crot., Digitalis, Gelsemium, Glonoin, Iberis, Ignatia, Iodium, Kali carbonicum, Kali iodidum, Kali muriaticum, Kalmia latifolia, Lachesis, Lilium tigrinum, Lithium carbonicum, Lycopodium, Lycopus virginicus, Mercurius, Moschus, Naja, Natrum muriaticum, Nux vomica, Phosphorus, Plumbum, Psorinum, Pulsatilla, Rhus toxicodendron, Spongia, Sulphur, Tabacum, Thyroidin, Vanadium, Veratrum album, Veratrum viride. To these may be added three which have been largely used of late in old school practice, Adonis vernalis, Convallaria majalis (the Lily of the Valley), and Strophanthus.
I will now briefly sketch the leading indications for the use of each. Symptoms taken direct from the Materia Medica are in inverted commas.
Aconite is likely to be called for in all inflammatory affections of the heart (especially those accompanying rheumatic fever), in hypertrophy of the heart, fainting, palpitation and angina pectoris. In all heart disturbances caused by fear, or fright, or anger, Aconite is the first medicine to be thought of. With the Aconite heart there is anxiety and pallor; faintness on sitting up. In the cases where fever is present there in intense restlessness and mental tension; in other cases there is coldness and collapse. In all cases where the characteristic fear of death is present, and especially when the patient is clairvoyant and predicts the time of death, Aconite will do all that is required.
The pulse of Aconite is rather hard, strong and contracted, or else it is feeble.
There are shooting and pricking pains in the chest; great oppression of breathing; sense of anguish in the chest; intense pains in all directions, especially down the left arm, with numbness and tingling.
“Tingling of the fingers of left hand as if going to sleep, with anxiety” is very characteristic of Aconite heart affections. There is relief from lying on the back with the shoulders raised. Suited to plethoric individuals.
A leading feature of this drug is somnolence, with rattling of large bubbles in the lungs, purplish hue of lips from imperfect oxygenation. Dilatation of heart; crushing weight on sternum when attempting to ascend a height (like Aurum, but the latter has not the somnolence); intense intolerance of a warm room; cough with bloody sputum; palpitation with dyspnoea and retractation of epigastrium; cyanosis. Ammonium carbonicum is a venous medicine and corresponds more to the right heart than the left.
This drug has been called the “vegetable trochar,” on account of its powerful action in removing dropsies by diuresis. The best account of it is to be found in the “Homoeopathic Recorder” for November, 1892, in a lecture by Dr. S.A. Jones.
The chief indications are :-Oppression at the chest; this may be so profound as to make speaking difficult. The most characteristic pulse is a very slow pulse: this is the effect of large doses, but small doses have caused an exceedingly rapid pulse, so either may indicate the drug.
The most characteristic mental symptom is a bewildered state. A number of cases of tobacco poisoning producing heart symptoms and dropsies have been cured with this drug. It belongs to the same natural order as Strophanthus.
Apocynum has been almost exclusively used in the lowest potencies. According to Dr. Jones, watery infusions with just enough spirit to keep them from fermenting are the most efficacious in dropsical cases.
The chief indications for the use of Arnica will be found in the history of injuries, strains or over-exertion. Heart affections in athletes will require this remedy.
Characteristic symptoms are :-“Bruised pains in the chest, and compression;” “Palpitation;” “Painful pricking in the heart, with fainting fits;’ “Cough with expectoration of blood.” Most suited to plethoric red-faced persons.
“Great oppression at the chest.” “Violent and unsupportable throbbing of the heart, chiefly when lying on the back and especially at night.” “Irregular action of the heart, sometimes with anguish.”
“Shivering or great heat and burning in the chest.”
Arsenic is called for in many conditions of weakened or degenerated heart. In order to secure its full action the constitutional indications for the drug must be present, or at least some of them. Great chilliness; desire for warmth; unquenchable thirst for small quantities frequently. Burning pains. Anxiety, restlessness, and excessive anguish which allows no rest, principally in the evening in bed, or in the morning on awaking, and often with trembling, and cold sweats; oppression of the chest; difficulty of breathing, and fainting fits. Unhealthy, dry, scurfy skin. Effects of over-indulgence in alcohol or tobacco.
Many cases of angina pectoris and fatty heart will need this drug. It affects the left heart more especially (Phosphorus the right).
As many of the cases narrated in this work were treated with Iodide of Arsenic, it may be well to state here how I first came to use it.
As far as I recollect, it was from observing the marked improvement in the heart symptoms of patients suffering from both pulmonary and cardiac disease, when I had been led to choose the medicine from the lung symptoms alone. Believing that the improvement was due to the direct action of the salt on the heart, and not to its action on the lungs only, I next gave it in cases where the lung symptoms were not such as would call for it, and then I found its action on the heart was just as marked and just as beneficial as in cases of pulmonary and cardiac disease combined.
Our provings of the salt are very scanty, and beyond irregularity of the pulse, noted by one of the provers, there is nothing in the pathogenesis of the Iodide that would lead us to suppose it had great power over the heart. But the clinical experience of its action in cases of lung disease, which proves that it possesses in large measure the combined powers of its two elements, would be a strong a priori argument in its favour as a powerful heart medicine, both Arsenic and Iodide having a very decided action on that organ. My own clinical experience proves that this is the case. It seems to act on the heart muscle,. arresting degeneration and restoring vitality. The coexistence of a chronic cough or chronic lung affection is the chief indication of preference over Arsenicum alb.
The salt in trituration is not very stable. I have used it almost exclusively in the third decimal trituration, but the alcoholic tincture of the same strength is a very active and reliable preparation.
“Great difficulty of breathing at night and on walking in the open air, requiring deep inspirations.” “Continuous aching in left side of chest.” “Beatings of the heart irregular, or by fits, sometimes with anguish and oppression of the chest.” “On any attempt to walk uphill, or on any little exercise, feels as if there were a crushing weight inside the sternum. He feels that if he did not stop walking the blood would burst through the chest.”
The mental sphere gives the great indication of Aurum : Melancholy and inquietude, with desire for death; despair; great anguish inducing a disposition to suicide. Other leading symptoms are : “Giddiness and fainting;” “Great sensitiveness to cold and yet a strong desire to go into the open air, even in bad weather, because it is found to be a relief;” “Aggravation of all symptoms at night from sunset to sunrise.”
Aurum is one of the chief antidotes to Mercury and is called for in cases of over-dosing with that drug; in syphilitic and mercuro-syphilitic cases; in fatty degeneration of the heart and arteries. In patients whose pulses are hard and unyielding from calcareous deposit there is often found the mental condition of Aurum and in such patients it will do excellent work.
“Difficulty of breathing with sensation of fullness in the chest.” “Pains in the chest relieved partly by eructations and partly by external heat.” “Fullness and pressive heaviness on the chest, especially when ascending, with stitches, especially on inspiration.” “Very violent throbbings of the heart.” “Throbbing of the heart excited by lying on the left side, or renewed by thinking of it.”
Baryta carbonica has many symptoms of paralysis and degeneration of tissue : “Heaviness of the whole body;” “Necessity to lie down or be seated;” intellectual, nervous and physical weakness. It corresponds to scrofulous and glandular affections. It is a “chilly” medicine and is indicated by the consequences of chill. It is equally applicable to affections of the heart itself and of its vessels, having cured numbers of cases of aneurism.
The symptoms of Baryta mur. are much like those of Baryta carb. and Baryta acetica and were originally published together in the same schemes. The salts of Muriatic acid have such strong affinity for the heart that it might be expected, a priori, that the cardiac action of the muriate would be more powerful than the carbonate. I cannot give any clearly differentiated symptoms to distinguish between the two. Allen gives under the muriate: “Beating of the heart irregular, pulse scarcely perceptible;” ” Pulse rapid, full;” “Pulse soft and irregular;” “Pain in the back.”
Hering mentions “palpitation,” “dyspnoea,” “oppression,” “trembling” and “paralytic weakness.” It is suited to scrofulous affections and persons subject to catarrh. In some conditions there is relief to breathing by sitting up with the head bent forward. It has cured a number of cases of aneurism.
The mineral water of Llangammarch in Breconshire, Central Wales, contains Baryta mur. in small quantities along with other chlorides, notably Natrum mur. An account of it will be found in the Homoeopathic World, Vol. XXVII (1892), p. 441. It has recently been advocated in the Lancet (November 24th, 1894, et seq.) as a remedy in heart disease and scrofula. Cases of anaemia with gastric catarrh had dilatation of the heart have received remarkable benefit from this water.
A leading feature in the action of this drug is the intensity of the palpitation it causes. It extends from the heart to the minutest blood-vessels and hence arises the appropriateness of Belladonna for a great variety of inflammations in which throbbing pains are marked. “Violent beatings of the heart (which are sometimes felt in the head).” “Palpitation of the heart when ascending.” “Great inquietude and beatings in the chest.”
“Trembling of the heart with anguish and piercing pain.” “Shooting in the chest, sometimes as from knives and chiefly in coughing and yawning.” Respirations short, anxious and rapid. Pulse strong and quick, or full and slow, or small and quick, or hard and wiry. Belladonna conditions are often induced by chill, especially chill after hair-cutting. There is often redness and bloatedness of the face. It acts best in persons of lymphatic or plethoric constitution, especially persons with blue eyes, light hair, fine complexion and delicate skin.
There are very few heart conditions in which Belladonna may not be called for according to the general and local conditions of the drug.
For this polychrest to be indicated some of the leading characteristics among the general symptoms of the medicine must be present : Anxiety, inquietude, fear of the future. Discouragement. Irascibility and passion. Aggravation of all symptoms on movement, better when lying on painful side or painful part; frequent nose-bleed; lips dry, swollen and cracked; indigestion; thickly coated tongue; sense of weight or stone at chest, worse after meals; constipation; disagreeable, vexatious dreams; dreams of transactions of the day; starting with fright on going to sleep and during sleep. Some of these symptoms should be present as well as local conditions :-“Pressive pains in precordial region;” “Stitches; cramp; oppression; tearing stitches in left side of chest from behind forward, better from rest, worse from motion and deep inspirations.” “Palpitation; heart beats violently and rapidly.”
“Pulse full, hard and rapid.”
Bryonia corresponds to many forms of rheumatism and is indicated in many acute inflammatory affections of the heart, and effusion into the pericardium.
This powerful heart-medicine, which we owe to the celebrated Dr. Rubini, and the heroic provings of it by himself and his devoted wife (whose health it is to be feared was permanently impaired by her experience) has recently been discovered and appropriated without acknowledgment by allopathic writers. Cactus has one grand key-note symptom distinguishing it from all other drugs. In many cardiac cases there is a painful sense of constriction about the chest or in the heart itself. When a patient complains of a “sensation of constriction in the heart as if an iron band prevented its normal movement,” there is no other medicine to be thought of until Cactus has been given. Cactus, however, will cure many cases of heart disease in which this symptom is not present when other symptoms correspond.
Pricking pains (as the prickly nature of the plant might suggest) are almost as characteristic as the constricting pains. “Pricking pins impeding breathing and movement of body; oppression; cannot lie on left side; blue face; pulse quick, throbbing, tense, hard.” “Acute pains and stitches in heart.” “Very acute pain, and such painful stitches in heart as to cause him to weep and cry out loudly, with obstruction of respiration.” “Dull heavy pains in region of heart, worse by external pressure.” “Palpitation violent, aggravated by walking and by lying on left side.” “Rapid, short, irregular beats of the heart, on rapid motions, on slow walking, rising from a chair or turning suddenly.”
“Slight excitement or deep thought brings on palpitation.” “Nervous palpitation increases gradually with the onset of the catamenia.” There is irregular and intermittent movement of the heart. Pulse hard and sudden without being frequent. The heart symptoms often compelled the prover to stand still when commencing to walk and to inspire deeply several times. One peculiar symptom experienced was a “sensation of very annoying movement, from before backward in the cardiac region, as if a reptile were moving about in the interior; worse by day than by night.” The usual time of aggravation of the “Night-blooming cereus” is the evening and night.
A tendency to haemorrhages is a distinguishing feature of Cactus grand.
The other members of the Cactus family are potent heart remedies, notably CEREUS BONPLANDII, which has among other symptoms the following: “Sensation of a great stone laid on the heart; soon after, sensation as if the chest was broken out just in front of the heart.” “Feeling as if the heart was transfixed with a blunt instrument like a bolt.” “Slight pricking pain at the heart.”
One of the leading antipsoric medicines, corresponding to many forms of rheumatism, Calcarea cannot be left out of sight in a catalogue of heart remedies. Its systemic symptoms will be the best guide to its use : “Apprehension, fearing consumption and heart disease.” “Ill-humour, obstinacy, and disposition to take everything in bad part.” Obesity or emaciation. Great chilliness, sensitiveness to open air; coldness and clamminess of hands and feet, feeling as if stockings were damp. Cold sweat of head and chest. Acidity, heartburn, hunger soon after eating. Menses too early, and too profuse. Stiffness of limbs; painful swellings of joints and nodosities on fingers and toes.
In the chest we have “Shortness of breath chiefly an ascending.” “Wheezing respiration.” “Anxious oppression.” “Burning.” “Palpitation of the heart, also at night, and after a meal, sometimes with anxiety and trembling movement.”