“Pulse full and accelerated, with erethism, frequent at night, slower by day; when slow, weak and trembling.”
MOSCHUS.
Musk corresponds very closely to the cataleptic state and hence to fainting fits in all degrees whether there is organic change in the heart or not. “Weakness to the extent of fainting, with nocturnal coldness of the skin generally.” “Fainting fits especially at night, in evening, or in the open-air.” “Anxious palpitation.” “Apprehension of death and excessive timidity about dying.” “Sensation of coldness mostly in the spine with drawing pain.” “The air seems cold; the patient seeks the fire-side.” “Great susceptibility to the open-air.”
NAJA.
In angina pectoris, valvular disease, threatened paralysis from diphtheria, hypertrophy, and effects of grief, Naja takes an important place. Disorders of other organs in which the heart is affected sympathetically, as palpitation accompanying ovarian affections. “Depression and lowness about the heart.” “Sensation as though a hot iron had been run into heart and a hundred-weight put upon it.” “Inability to speak, with choking, nervous, chronic palpitation.” “Severe pains in left temple, cardiac and ovarian regions.”
“Sensation as if heart and ovary were drawn together.” “Pains about heart extending to nape of neck, left shoulder and arm, with anxiety and fear of death.” Pulse slow, irregular in rhythm and force. Symptoms worse at night; walking; lying on left side.
NATRUM MURIATICUM.
My attention was first was first markedly drawn to the power of Nat. mur. as a cardiac medicine by the signal relief it gave many years ago to a patient, an elderly woman, suffering from extreme hypertrophy due to valvular disease, to whom I had given it principally to relieve constipation. She said nothing had given so much relief to her heart symptoms before. Natrum muriaticum has in its pathogenesis:-
“Anxious and violent palpitation of the heart at every movement of the body, but principally when lying on the left side.” “Irregular and intermittent palpitation.” “Jerking movement of the heart.” Palpitation and intermittent of accelerated pulse after a meal.” “Jerking and shooting pain in the region of the heart.
Natrum muriaticum is the “chronic” of Ignatia, and it corresponds to many so-called hysterical conditions. There is melancholy with much sadness and inclination to weep, and the patient is made worse by any attempt to give consolation. The bad effects of a disappointment.
Consequences of self abuse. Results of intermittent fevers in which quinine has been given to excess. The symptoms are worse when lying down, especially at night and in the morning; better from rising up in bed; worse after sleep. The sleep is agitated, dreams of robbers, murders, fire, etc.
NUX VOMICA.
“Pulsation in the chest and side.” “Shootings and blows in the region of the heart.” “Palpitation, worse principally after dinner; when lying down; or in the morning; accompanied by nausea, inclination to vomit, and sensation of heaviness in the chest.”
Nux vomica, being one of the polychrest medicines, may at any time be indicated in a cardiac case. The above are the chief symptoms occurring in the heart itself, but the following chest symptoms strongly indicate its use:-
“Asthmatic constriction and oppression, worse at night or in the morning, or in bed in the evening; when lying down; when going up an ascent; when walking; after dinner; often accompanied by a choking anxiety; pressure in the epigastrium; humming in the ears; quick pulse, and sweat.” “Slow, wheezing respiration.” “Tensive pressure in chest as from a weight, principally at night and in the open air.”
The sensitiveness, irritability an chilliness of Nux vomica, sensitiveness to open air, sour smelling breath, constipation, early waking (3 a.m.) and falling asleep just when it is time to rise-must all be taken into consideration in prescribing this medicine.
PHOSPHORUS.
“Obstructed respiration and oppression of the chest of various kinds; especially in the morning or evening; also during movement.” “Anguish in the chest.” “Heaviness, fullness and tension in the chest.” “Lancinations in chest, particularly left side, sometimes prolonged or else when the parts are touched.” “Burning pain as from excoriation.” “Palpitation:-after a meal; morning and evening; when seated; after all kinds of mental excitement.” “Pulse quick and hard.” “Fainting fits.” “Ebullition and congestion of blood, sometimes with pulsation throughout the body.”
The typical Phosphorus patient is dark, tall, narrow-chested and stooping, phthisical and inclined to haemorrhage. Sufferings from chill and from anger call for it; pain in the limbs on change of weather; worse in open air especially when cold; worse morning; evening; in bed; after dinner; some symptoms appear at the beginning of a meal and disappear after it. A characteristic aggravation of Phosphorus is from lying on left side.
Another is worse from warm food and drink-a drink of cold water will remain in the stomach until it becomes warm and then it is vomited. Among the mental symptoms are-“Hypochondriacal sadness.” “Great irascibility, anger, passion, and violence.” “Shamelessness.” “State of clairvoyance.” There is amelioration after sleep. Sleep is disturbed by anxious, distressing dreams, frightful and horrible. Somnambulism.
Phosphorus causes fatty degeneration of all tissues, and many of its symptoms point to its applicability to forms of fatty heart and degenerated arteries; and also to venous stagnations. It corresponds more to affections of the right or venous side of the heart, Arsenicum more to the left.
PLUMBUM.
In cases of lead poisoning there is not unfrequently seen, in addition to paralytic symptoms, profound alteration of the arterial system and heart. In one case which came under my own notice, there were numerous aneurisms principally affecting the lower extremities. Lead sets up granular degeneration of the kidneys and the condition of hypertrophy of the heart which always accompanies this. it also produces hypertrophy and degeneration of the heart muscle independently. The special heart symptoms of Plumbum are “Violent spasmodic palpitation with anxiety at the heart.” 12
“Pressure on the chest with difficult breathing.” Pulse “small; slow; contracted”; or, it may be rapid.
The mental symptoms of Plumbum are “Melancholy”; “Gloom”; “Anxiety”; and “Mental torpor.” The great characteristic of the drug is obstinate constipation, stool in the form of balls, abdomen hard, muscles knotted, sense of constriction navel and anus violently retracted.
PSORINUM.
The distinguishing feature of Psorinum is to be found in the condition “better from lying down.” Almost all conditions of weakened heart and distressed breathing are better by propping up. When chest symptoms are better lying down, Psorinum will in all probability cure; though Psorinum must not necessarily be excluded in a case if the reverse, “inability to lie down,” is present.
“Pain in heart better when lying down, thinks the stitches will kill him if they continue.” “Gurgling in the heart, more particularly when lying.” “Palpitation: with anxiety, mental disquietude; dislike for work; from coughing; from liver disorders.” “Dyspnoea : with palpitation; with pain in cardiac region.’ The intense prostration of Psorinum, with desire to lie down; chilliness, even in hot weather wanting to be wrapped in furs; sensitiveness to stormy weather; irritable, unhealthy skin; fetid sweat and evacuations, will be sufficient to indicate the place of this remedy.
It is closely allied to Sulphur, which it follows well.
PULSATILLA.
The Pulsatilla type of patient is the opposite of that of Nux: Fair haired, fair eyed, inclined to stoutness; mildness and gentleness of disposition, easily moved to tears or laughter. Pulsatilla is indicated by shifting pains, passing rapidly from one part to another, worse when at rest, when seated, on rising after being long seated, when lying on the side (especially the left,) in the evening before midnight, in a warm room. Better in open air, walking about slowly.
“Shootings in the chest and sides principally at night and when lying down.” “Fits of suffocation: worse in evening, after a meal; at night; when lying down.” “Congestion of blood in the chest and heart especially at night.” “Frequent and violent palpitation, principally after dinner, after moral emotions, provoked by conversation, and often with anguish, clouded sight, impeded respiration, especially when lying on left side.” “Anxiety, nervousness, pressure, and burning sensation in the heart.” “Numbness, particularly about the elbow very frequently with hypertrophy or dilatation of right ventricle”(Farrington).
RHUS TOXICODENDRON.
This is one of the great rheumatic remedies, the characteristic feature of its pains being relief from motion. There may be aggravation on commencing motion but after the first movement further movement gives relief. (Bryonia “The more he moves the worse the pains are.”) As soon as the patient remains quiet the pains get worse, compelling him to move again. There is shivering and coldness in the Rhus patient, better from warmth, worse from damp air or from getting wet. Complaints after a wetting, worse at night. Anxious sadness and excessive anguish, especially in evening and at night; desire for solitude and inclination to weep; sleep disturbed by frightful dreams of fire; dreams of the business of the day.
