REMEDIAL POWER OF HOMOEOPATHY IN CASES OF CHRONIC HEART DISEASE.
WHEN once the muscular fibres of the heart have become weakened, so that the organ is no longer able to discharge its functions without effort, no matter what the cause of the weakening may have been, the symptoms are very similar-breathlessness and palpitation on the slightest exertion, inability to lie down flat, or to lie on the left side, pains in the heart of many kinds, and varying in intensity from very slight to the agonies of angina pectoris. These symptoms occur in chronic cases of valve disease, in cases of fatty degeneration of the muscular fibres of the heart, in accumulation of fat about the heart when it is an accompaniment of general obesity.
I will now relate a number of cases, all more or less chronic, in which chronic affections of the heart were materially and permanently relieved by homoeopathic treatment. I will first give some of the earlier ones from the series treated with Iodide of arsenic. Some of these cases are defective as therapeutic observations in that more than one medicine was given on the same day, but in spite of this I think it is possible to determine the action of the medicines given.
CASE XI.-MITRAL STENOSIS AND INCOMPETENCE WITH ANGINA. CO- EXISTENCE OF NASAL POLYPUS. PRACTICAL CURE WITH Iodide of arsenic AND OTHER REMEDIES.
Mrs. McC, age 52, rather above medium size, grey eyes, dark hair, thin, rather pale, consulted me April 22nd, 1882. She was taken ill in Scotland the previous July. She went to bed one night quite well, and woke up with a feeling as if the ribs were being pressed into the heart; for thirty-six hours was in agony. It was a month before she was well enough to travel to London. She still has the same sensation (of pressing-in of the ribs) and palpitation at the same time. Has had two or three attacks since that in July, but not so severe or long-lasting. Has frequent severe palpitation and rush of blood; is faint after the attack. In the night she wakes with a feeling of going over a precipice. If the feeling comes on when she goes to bed she cannot sleep at all and has to be propped up. She cannot go upstairs or exert herself, as it brings on pain in the side-not the pain at the heart; that comes on when she is quite calm and still.
She has a cough night and morning and raises much phlegm. Has to be very careful with her diet. Never was strong; for ten years attended the Victoria Park Hospital for Consumption. Had her right arm broken twice, at six and at sixteen.
Since the second break has had rheumatism in the arm, but never had rheumatic fever. On this day I had not time to examine the chest thoroughly, but I took the following sphygmogram, and told her to return in a week.
The sphygmogram taken on this day is of great interest, the beat being apparently triple. The beat, however, is not really triple. The first figure represents a natural beat. This is followed by a double beat, the secondary pulsation being so slight as not to be perceptible to the finger on the pulse. The second and subsequent sphygmograms show only double beats until, under treatment, the beats become quite normal and regular.
April 29th.-She reported that she had a very bad cold, and was coughing much; the cough being in fits. She raised a good deal of phlegm at night. Pulse 46.
I was now able to make a complete examination of the chest, with the result that the heart was found much enlarged and the valve action defective. Subsequent examination showed that it was the mitral valve which was at fault, being narrowed and incompetent. There was some anaemia, and some consolidation of the apex of the right lung. Here are the particulars of the examination on that date :-
Vertical dullness begins at lower border of third costal cartilage. Transverse dullness at level of fourth costal cartilage extends two and a half inches to the left of the sternum. This part is bulged forwards. The apex beat is felt, but very faintly; the impulse is felt near the sternum.
Sounds : regularly irregular. One strong beat is felt, followed by two smaller ones which make no impression on the pulse at the wrist. Sometimes there is a soft systolic bruit, and at the tricuspid area a rough bruit apparently diastolic. The heart-sounds are clear at pulmonary and aortic areas. Bruit de diable in neck.
Lungs : dullness and slight flattening with increased vocal resonance and fremitus at right apex exaggerated expiration.
Treatment Arsen. iod., gr. ij, night and morning after food; Digitalis I, one drop in water three times a day.
May 6th.-First part of week worse; twice she fainted right away, but last part of week much better, less fluttering, less flushing; cough looser.
Examination.-The secondary beat is felt like a thump at the apex, where a soft systolic bruit is heard with the primary beat; it is heard nowhere else. The region of the apex is very sensitive. Repeat medicines.
May 20th.-She is very much better; has not had the heart so quiet for months, only has palpitation now when called suddenly, and that only slight. Appetite good, but she cannot take meat.
Examination.-Action of the heart quiet and regular, but instead of the two sounds three are heard; after the systolic comes the diastolic and then a sort of rebound. With the systolic sound, in the mitral area and over the third left costal cartilage a soft systolic bruit is heard.
This is not heard with the third sound, and it is not heard to the right of the sternum. In the aortic area the first is very feeble and the second stronger. In the pulmonary area all three sounds are heard, but not the bruit. Repeat.
June 3rd.-Keeping very much better. Phlegm hard to raise.
Examination.-Lungs: prolonged expiration both apices and increased vocal resonance, the latter most marked on right side, with increased vocal fremitus. Heart-sounds much steadier, there is a thump with the first sound; a presystolic bruit can now be distinctly made out in mitral area; no apex beat is felt; cardiac dullness extends from half an inch to right of sternum five inches across.
Treatment Kali bich., 3; one drop to be taken occasionally when expectoration was difficult. Otherwise the same medicines to be continued.
After this I did not see the patient again for over a year. She returned on August 25th, 1883. Her condition on this date was as follows: Pulse82, has no pain at heart now, though she feels it weak and is faint; there is a presystolic thrill.
She came now to consult me on account of blocking of the nose and loss of taste and smell. I discovered a polypus in each nostril, the right the larger. Eighteen years before she had had polypus, which she said was burnt.
Arsen. iod. 3x was given night and morning; Thuja 3x, one drop in water four times a day; Thuja 0 to be applied with brush three times a day.
September 8th.-Heart better, pulse 76. Not so faint and low. Tastes better, can smell sometimes. Sleep poor. Repeat.
September 19th.-Unable to sleep since 15th; has the “falling” sensation; continual fidgeting with the limbs. Pulse regular.
Treatment Actea r. I, one drop four times a day; Coffea 3, one drop every hour if sleepless; Thuja 0 to be applied.
October 3rd.-Very much better. Sleep good after three days; fidgetiness better; nose better-less stopped. Repeat.
October 24th.-Very much better generally, can smell now and then.
November 14th.-Very much better; smells quite well, tastes better, sleeps well. Repeat.
December 5th.-Very much better as regards the polypus, it gives no inconvenience now. Heart troublesome again; sleep not so good. Has pressure on the back of the head. The application of Thuja now causes pain.
December 29th.-In the early part of this year she had a great shock-the news of the wreck of a ship on board of which she had a son. She was for many days in suspense as to his fate, but learned at last that he was among the saved. She does not think she has been well since the shock. She has nausea after all food. Tongue white; bowels confined. Has pain in the side. Nose fairly clear. Presystolic still heard, only faintly, at apex. Pulse a little irregular; cough in fits; sleep bad till she used Coffea. Thuja still causes pain.
Treatment Arsen. iod. 3x, a grain night and morning; Ignatia I, one drop four times a day; Thuja application.
January 12th, 1884.-Very much better. Had a faint on December 31st, but much better on the 2nd and has continued so. Bowels rather difficult Nose a little stopped; has flushes. Repeat.
February 23rd.-Says she is “pretty well,” the polypus is the worst of her troubles. Is losing taste and smell; has rheumatism in left foot and arm.
Treatment Thuja 3x, one drop three times a day; repeat Thuja locally, and Arsen, iod. night and morning.
March 12th.-Better; nose better, tastes better, has little pain. Repeat.
April 12th.-Has neuralgia; nose pretty well, has been able to smell for the last fortnight.
Treatment Spigelia I, one drop four times a day.
This case was two years under observation. The patient came originally for an opinion merely, not expecting to receive much benefit, as she knew she had heart-disease and considered it hopeless. She was restored under treatment to activity and comfort, and I ascribe the chief share of the credit to the Iodide of arsenic.