The secondary effect of Digitalis is, to cause weakness of the heart, with irregularity of action; and this condition is reflected by every organ and tissue.
The discriminating physician, after fixing in his mind the method of action of Digitalis, can read the provings of that medicine with an interest altogether new. He will find mixed confusedly together the primary and secondary effects of the drug; but they can be separated, classified, and made to serve a valuable use as indications for this potent remedy.
In the final consideration of this subject, it is necessary to inquire how far we can make practical use of this discussion. Can we point out the conditions in which Digitalis will prove useful, and the dose requisite to cure?
Among the quite extensive list of affections which Noack and Trinks have recorded, as indicating the use of Digitalis, we shall mention only a few, to illustrate our views. We shall also allude to its successful use by Allopathic physicians.
Among the symptoms of the mental sphere and the brain indicating
17 Digitalis are mentioned: “Melancholy,” “Dementia,” “loss of memory,” etc. In the pathogenesis, however, we find: “Vivid fancies,” “delirium and restlessness,” etc., all of which are primary symptoms; while the weakness of memory, gloominess, dulness, inability to think, etc., are secondary symptoms.
Another series of secondary symptoms may, however, be developed, after the heart has become too weak to supply the blood in sufficient quantities to the brain. These symptoms simulate delirium tremens.
It is the Homoeopathicity of Digitalis to irritation of the brain, with deficient nutrition, from lack of due supply of blood, that makes it a curative agent in nervous fevers and the mania of drunkards.
As remarked by Dr. Madden, alcohol must act as an antidote to Digitalis, else such large doses as have been given in such cases could not have been borne; for when the powdered leaves are given, a large dose causes aggravations.
Digitalis has been found of great value in neuralgia. We cannot explain its action as being similar to that of the Belladonna group. A glance at the true pathology of neuralgia will tell us how it acts. When not caused by organic disease, neuralgia is the result of deficient nutrition. The nerves become irritable, and show the irritation by pain, just as an enfeebled brain shows it by delirium. Digitalis, by strengthening the weak heart, causes it to increase the supply of blood to the brain and nerves, and, as a result, delirium and pain cease.
Hahnemann’s provings developed some neuralgic symptoms; and in Hanfield Jone’s Treatise on Diseases of the Nervous System, p.321, we find an account of its usefulness in the treatment of prosopalgia.
In diseases of the stomach, particularly those of a functional character, and due to deficient nutrition – as most of them are – Digitalis is a remedy of greater importance than has been supposed.
In the pathogenesis we find many notable gastric symptoms. Besides the intense nausea and the vomiting, we note a peculiar sensation of “weakness of the stomach, as if he would die;” “a sinking sensation,” which finds its simillimum in Ignatia, Tabacum and Cimicifuga. Those who have had much experience in treating cardiac difficulties must have frequently noted this prominent symptom. It is a characteristic symptom of a weakened heart which cannot supply the stomach with its accustomed stimulus. One of the most intractable forms of dyspepsia has its origin in this condition, and finds its true and prompt remedy in small doses of Digitalis. One of the most practical physicians of my acquaintance informs me that he finds in Digitalis one of his most useful remedies in indigestion, heartburn, acidity, nausea and vomiting of ingesta, and many unpleasant sensations which dyspeptics feel after meals. The intestinal symptoms of Digitalis are due not so much to a specific influence of the drug on the bowels as to a debilitated heart. There is a diarrhoea; but we fail to find evidences of actual inflammation of mucous membrane. Digitalis may prove a valuable remedy in cholera, by its Homoeopathic action on a weakened heart; but I imagine it will prove most useful in those choleroid conditions due to mental emotions, such as fright, anxiety or nervous prostration.
Hahnemann noted one variety of diarrhoea, which demands a more than passing notice. I refer to the following symptom:
“Ash-colored, papescent stool, as in a person affected with jaundice; previous to stool, four attacks of vomiting, with previous faintness.”
The kind of diarrhoea is evidently due to no kind of intestinal irritation, but to disturbed function of the liver.
This brings us to a consideration of the use of Digitalis in diseases of that viscus, and especially that condition known as jaundice. One of the most important functions of the liver is to eliminate the constituents of bile from the blood. If the normal activity of the ultimate hepatic cells is lessened, such an elimination is wholly or partially arrested. In either case, we have jaundice in a greater or lesser degree. The natural stimulus of the hepatic cells is found in the normal supply of healthy blood. If this fails, their action becomes labored and inefficient.
Digitalis, by its secondary effect on the heart, lessens the force of the circulation, and brings about the identical condition referred to. Every physician has observed the frequency of jaundice, or hepatic torpor, in connection with some varieties of heart disease. It is in this class of cases that Digitalis becomes one of our most useful remedies, not only in cardiac affections, but in many conditions which originate in the liver – conditions which depend on atony of the hepatic cells.
Noack and Trinks mention, particularly, icterus, or jaundice, accompanied by a certain group of symptoms, as coming under the curative influence of Digitalis. It is rarely used, however, by Homoeopathic physicians for that condition. My first experience with Digitalis in jaundice was in the early part of my practice, when, in an obstinate case, which resisted all the usual remedies, I resorted to Digitalis, with but slight faith in its powers. I was agreeably surprised, however, to find it promptly curative. Since that occurrence I have used it in many cases of jaundice, more or less severe, and with good results. In one case, the jaundice was the result of the pathogenetic action of Myrica.* *See Hale’s New Remedies, page 735. Other remedies failed to restore the function. Digitalis, however, in drop doses of the mother tincture, soon brought about the secretion of bile.
The action of Digitalis on the kidneys is one of the most important, but one of the least understood.
Allopathists believe it to be a powerful diuretic, causing, when it does act in that direction, a copious elimination of aqueous urine, containing but a small quantity of solid matters. They note, however, that it does not seem to affect the kidneys in this manner, until after it has had a perceptible effect on the heart.
Hahnemann believed that the usual primary action of Digitalis on the kidneys was to cause “difficulty of urinating,” or “continual desire, with very scanty emission,” or even “retention of urine.” He notes, in one place, that retention followed enuresis, but remarks that this is a rare secondary effect.
I believe the real action of Digitalis on the kidneys may be thus described:
Small quantities, frequently repeated, cause, in the healthy organism, an increase in the force of the circulation. This results in an unusual flow of blood into the kidneys, stimulating them to increased elimination of water from the blood. If the dose of Digitalis is toxical, retention may occur without the previous diuresis; but if the pathogenetic doses be long continued, the weakened heart fails to supply the renal organs with sufficient blood, and a decrease of urine occurs, leading, sooner or later, to dropsical effusion, from the non-elimination of the watery portion of the blood.
If Digitalis be given to a person with a heart already weakened by disease, diuresis immediately occurs, and the normal discharge of urine returns.
On these results we may base the following propositions: 1. Digitalis is homoeopathic (primarily) to profuse and frequent discharges of urine of a watery character, and attended with a quick pulse.
2. It is secondarily homoeopathic to scanty, infrequent urine, loaded with solid matters, attended or not with pain, dropsical effusion, hepatic torpor, cardiac debility and irregular, or slow, intermitting pulse.
3. If used for diuresis, diabetes or incontinence of urine, Digitalis must be prescribed in the higher attenuations.
4. In conditions to which it is secondarily homoeopathic, the lower attenuations, mother tincture, or even the infusion, must be used, if we wish to get curative results.
These two last propositions are in accordance with my Law of Dose, which is well known to all reading physicians of our school.
Hahnemann taught that the diuretic properties of Digitalis in dropsy are antipathic; but he admits that they ar continuous. Had he investigated the action of the medicines still further than he did, he would have discovered the law which governs the selection of a dose as resulting from the duality of medicinal action.
Hale wrote Lectures On Diseases Of The Heart, Materia medica and special therapeutics of the new remedies Volume 1, Materia Medica And Special Therapeutics Of The New Remedies Volume 2, Saw Palmetto: (Sabal Serrulata. Serenoa Serrulata), The Medical, Surgical, and Hygienic Treatment of Diseases of Women, New Remedies: Their Pathogenetic Effects and Therapeutic Application, Ilex Cassine : the aboriginal North American tea, Repertory to the New Remedies with Charles Porter Hart, The Characteristics of the New Remedies, Materia Medica and Special Therapeutics of the New Remedies, The Practice of Medicine, Homoeopathic Materia Medica of the New Remedies: Their Botanical Description etc.