I saw him several times within the week. On one occasion I found the pulse normal in force and rhythm, and I then indulged the hope that the condition might turn out to be functional only and transient.
The next day I found the pulse irregular and intermittent or very frequent. The patient (who was unmarried) wished to go to stay with some relatives, and I thought this was the best thing he could do. I have since heard that he died not long after leaving town. He died of-Iodide of potassium.
I cannot be denied that in some cases large doses of Iodide of potassium do seem to benefit, and in some cases of aneurism encouraging success has attended the treatment. My own impression is that, when good result, it is in the cases where there is a strong element of active syphilis at work; the one poison seems to antidote the other. Where there is no syphilis or only a very slight amount, massive doses of Kali iod. produce irremediable mischief.
Here are symptoms from the pathogenesis which it will be seen correspond pretty closely to those of my patient :- “Fluttering on awaking, giddy; must get up, fearing otherwise that he will smother.” “Fluttering of heart and nervousness; feels very weak.” “Palpitation, worse while walking.” “Darting pains in heart when walking, after abuse of Mercury; after repeated endocarditis.” “Pulse accelerated.” Profound adynamia will be a leading indication for the use of the drug.
Kali iod. is useful in cases which have been treated with Mercury. In aneurism it has a specific effect, though it is mainly given with the notion of lowering the patient’s strength, and especially the blood pressure, so as to give the blood in the aneurismal sac an opportunity of clotting.
KALI MURIATICUM.
The salts of muriatic acid have a powerful action on the heart, and Kali mur. is no exception. It is one of Schussler’s remedies, and he recommends it for that condition of the blood which favours embolus; in the exudative stage of inflammatory affections of the heart; in palpitation from excessive flow of blood to the heart; and in hypertrophy. The symptoms which call for it are: “Palpitation with constriction of the chest.” “Perceptible, but not accelerated beating of the heart, with coldness in cardiac region.” “Pulse accelerated, or soft and sluggish.” A white coated tongue is an indication for Kali mur., which is very analogous to Bryonia in its action.
KALMIA LATIFOLIA.
Kalmia Latifolia belongs to the Ericaceae like Ledum and Rhododendron. Like Ledum, its pains travel from below upward, and it is therefore suitable for rheumatic affections which leave the limbs and attack the heart. The pains are sharp and take away the breath.
Pains shoot down into abdomen and stomach. The pulse is slow. With the heart symptoms there is numbness of the left arm. Numbness of parts after pain has left. Pains move from place to place.
LACHESIS.
“Vertigo and fainting from heart weakness”; “palpitation and fainting.” “Trembling.” “Palpitation with a feeling of constriction, as if the heart were tightly held with cords.” “Sense of oppression with cold feet; as the feet get warm the oppression is relieved.” “Flushings, throbbings, cold feet, chilblains.” “Heart feels as if too large for the chest.” “Palpitation with numbness of arm, choking from slightest exertion; relieved by sitting down or lying on right side.” The conditions are all-important in Lachesis. Worse after sleep; worse on closing eyes; intolerance of slightest constriction in any part; intolerance of touch; worse when a discharge fails to appear and better when it does appear. This points to its use in climacteric sufferings.
Irritability of temper is an indication for Lachesis.
LILIUM TIGRINUM.
The characteristic sensation of Lilium is some what like that of Cactus, a sensation as if the heart was grasped, but there is a difference.
The “iron band” sensation of Cactus is not present with Lilium, nor is the constriction of the latter so enduring.
“Sensation as if heart was grasped, or squeezed in a vice; as if blood had al gone to heart, producing a feeling as if he must bend double : inability to walk straight.” “Heart as if violently grasped, then suddenly released, alternately.” “Constrictive pain about heart through to scapula.” “Sharp pain extending from left nipple through chest to back,” indicates Lilium in many heart conditions. “Sensation as if heart was overloaded with blood and it would be a relief to bring up some.” “Frequent sensation as if heart stopped, followed by rush of blood to heart and palpitation.” “Pain, dull pressure and fullness, with feeling of coldness about the heart.” “Heaviness.” “Irritability.” “Fluttering and faint feeling.” “Conscious pulsations over whole body.”
The symptoms are worse by eating ever so little; worse lying on either side; better sitting still.
The mental symptoms of Lilium are characterised by a sensation of hurry combined with a feeling of importance. Like other drugs which cause venous engorgement, it has amelioration in open air and taste of blood in the mouth, also scanty menses. There is a tendency to prolapsus uteri with bearing down or dragging down.
LITHIUM CARBONICUM.
The chief feature of the Lithium heart symptoms is the concomitance of symptoms of the urinary system. “Pressing in region of heart on rising to urinate, better after urinating.” Pains in heart before and at time of urinating; also before and at time of menses.” “Rheumatic soreness about heart, worse on stooping; pains in limbs; finger joints tender and painful; sleeplessness.” “Violent pain in region of heart as she bent over the bed; morning after rising.”
Lithium has proved of great service in valvular affections of the heart, and the condition left after acute inflammation. A concomitant of the heart symptom is “On inspiring, air feels cold even into the lungs.”
LYCOPODIUM.
It is more in the general symptoms of Lycopodium than in the special heart symptoms that the indications for its employment will be found.
“Sadness and apprehensiveness, weeps all day, cannot calm herself; sensitiveness, weeps when thanked; irritable, peevish, misanthropic; omits words and letters when writing, uses wrong words; headache, better by uncovering; sinking sensation at pit of stomach, worse in afternoon; fullness after the least food; excessive flatulence; constipation; red sand in urine; burning as from hot coals between scapulae, aggravation of all symptoms in afternoon from 4 to 6 or 4 to 8 p.m..”-These are the leading features of the Lycopodium patient, and some of them, should be present in cases for which it is prescribed.
I will now give some of the special symptoms :- “Palpitation especially during digestion, and in bed in the evening, sometimes with anxiety and trembling.” “Lancinations in the chest, especially the left side.” “Sensation as if the circulation stood still.” “Pulsating tearing in region of heart.”
In all kinds of weakened heart Lycopodium may find a place, and in aneurism and diseases of the arteries. In the last stages of heart disease when the lungs become secondarily engorged, it often renders great help. Iodine and Lycopodium are complementary medicines.
LYCOPUS VIRGINICUS.
This medicine has proved of service in many forms of heart disease-valvular affections, hypertrophy, exophthalmos and aneurism. There is irritability and erethism of the heart with debility. The patient is nervous and irritable, extremities cold. Cough with haemoptysis in connection with heart. affections. Palpitation and heart distress, worse morning and evening and when thinking of it. Heart’s action tumultuous and forcible, can be heard several feet from the bed. Laboured action. Heart beats slow and weak.
MERCURIUS.
In the days when it was the fashion to put everybody who was unfortunate enough to enter a hospital under the influence of Mercury, it was no uncommon thing to have patients drop dead from heart failure when simply walking across a hospital ward. Thus Mercury, like its dynamic antidotes, Iodine, Kali iod., Carbo vegetabilis, Lachesis and Belladonna, finds a place in the treatment of states of weakened and degenerated heart. It is no less appropriate when the weakness is occasioned by acute inflammatory states-endocarditis, pericarditis, with or without effusion, and especially when the inflammation is rheumatic in nature.
The leading indications for Mercurius in general are aggravation at night: profuse sweat which does not relieve, and is offensive in smell; tremor; sensitive to atmospheric changes, worse from both cold and heat; worse in damp weather. Tongue large and flabby, indented by the teeth; white coat; offensive breath. Blood-streaked purulent discharges are a strong indication for Mercurius.
The special heart symptoms are :- “Weakness at heart as if dying.” “Awakens with trembling at heart and agitation as if frightened.” “Aching pain at apex of heart, extending upwards towards base; cardiac oppression.’ “Palpitation with fear; worse at night; on slightest exertion; with cough and bloody expectoration.”
