In the above paragraphs has been summed up all the knowledge that is obtainable in regard to the action of Neirin upon the animal organism. It appears to show that the drug really does belong to the Digitalis group of poisons; but before our knowledge can be considered at all definite, it is essential that a much wider series of experiments should be made.
Under the control of Dujardin Beaumetz, Dr. Pouloux has made a few studies of the influence of Oleander in cases of heart disease.
He affirms that under its action the beat of the failing heart has become regular, and the filiform, imperceptible pulse full and hard. In several of the cases there has been marked increase of the urinary secretion, and in some the disappearance of widespread oedema. He administered the extract in pill form in doses of five centigrammes.
**281 to 261** THE ACTION OF SCOPARIOUS (BROOM) AND ITS ALKALOID, SPARTEINE, ON THE HEART.
Broom is a very old English remedy for dropsy. It is a common plant or shrub, growing all over England, and was used for dropsy by the people long before it was used by the regular profession. In Culpepper’s Herbal it is recommended as a purgative and diuretic, and for scurvy, dropsy, sciatica and jaundice. In large doses it causes considerable irritation of the kidneys and urinary passages. The ashes contain a large quantity of carbonate of potassa, to which its virtues were once supposed to be due. It has a volatile principle which was supposed to be similar in its effects to conia and nicotine.
No provings have been made by the Homoeopathic school, but its active principle, Sparteine, has been made the subject of recent experiments by Allopaths. But this principle, which was supposed to be volatile, is now proved to be the one which acts specifically upon the heart. Another active principle, Scoporin, isolated by Dr. Stenhaun, was supposed to be its diuretic principle, but Schroff, who tested it in several cases, observed no diuretic effects – only colic and borborygmi. A decoction of the tops of the plant is the official preparation, but a tincture of the seeds is pronounced more active in dropsy.
Like many other cardiac remedies, it is probable that it acts on the kidneys and urinary passages, as well as upon the heart, as do Digitalis and Adonis. Homoeopathic provings should be made of a perfect tincture of the whole plant, seeds and all, if we wish to get a picture of its general effects.
Dr. Cullen was the first to introduce it into regular practice, after hearing of its popular uses.
He employed it in dropsy, directing half an ounce of the fresh tops to be boiled in a pint of water, down to one-half that quantity. Of this he prescribed two tablespoonfuls every hour until it operated by stool. It seldom failed, he says, to operate both by stool and urine, and by repeating the dose, every day, or second day, some dropsies were cured. Sydenham used the ashes of Broom successfully for an anasarca, which followed an epidemic catarrh which prevailed in Sweden in 1757. Dr. Itard relates that about 1788, the French government published, as a specific for dropsy, a prescription consisting of the powdered seeds of Broom, and that it had “almost miraculous effects.” Dr. Pierson considered it superior to other diuretics, as it “improved the appetite and invigorated the whole system.” He states that it was most successful in ascites and general dropsy. Pareira declared that it was more certain than any other diuretic. “Indeed,” he says, “I cannot call to mind a single case in which it failed to act on the kidneys.”
All this is pretty strong testimony, but at the time of the above writers the pathology of dropsy was a mass of chaotic opinions. The causation of the various forms of dropsy had not been investigated, and especially the part played by a diseased and weakened heart was quite unknown. Only lately has broom been known to be useful in cases of cardiac dropsy. You will see that its history resembles that of nearly all cardiac remedies. Even Apocynum cann., which until within a few years was supposed to be a purely renal remedy, is now believed to owe all its virtue in dropsy to an alkaloid, Apocyninin, which acts as a cardiac tonic.
It is true that none of these active principles or “glucosides” act just alike. They cannot be used indiscriminately for cardiac dropsy. One case may yield to Digitaline – another will not, but can be cured by Adonidin. One will have its remedy in Convallarin, another in Sparteine, and so on. Sparteine or the Sulphate, which is better, does not act like Strophanthine.
The late experiments of Dr. Gluzinski, both physiological and clinical, with the Sulphate of Sparteine, show that its main action is to slow the heart, and to raise the blood-pressure. Now, in all cardiac dropsies, the failure of the kidneys to carry off the fluids is due to a lowering of the blood-pressure, especially in the kidneys.
Sparteine acts with greater intensity on cold-blooded animals than on mammalia. Its action on the latter may be divided into three periods or stages, during the first and last of which the effects are more marked than during the second. Indeed, in some cases, the heart is even quickened during the second period. This may be explained by the existence of some abnormality or pathological change in the irritability of the vagus, or the heart muscle. The reflexes are at first increased, afterwards diminished. Death occurs from asphyxia, and is due not only to the effect on the medulla, but to that experienced by the respiratory muscles. The therapeutic effect of Sparteine is limited to the first stage of its action. Its value consists in the rapidity with which it acts. In some cases within an hour after the first dose, the pulse begins to improve, as well as the subjective sensations of the patient, and no irregularity is produced. (In this respect it ranks after Glonoin, whose effects on a failing heart are observed in less than half an hour). Sparteine has not so powerful an action as Digitalis. It may, however, be useful in cases where the condition of the patient renders it inadvisable to wait for the more tardy effect of Digitalis, and it may therefore be used as an adjunct to the latter drug, besides which it may be prescribed where circumstances exist which contraindicate the use of Digitalis.
The foregoing is the opinion of Dr. G., but further experience may modify or change the estimate. But it certainly bids fair to be a valuable addition to our cardiac remedies.
Dr. Germain See uses Sparteine largely in his clinic in Paris for mitral insufficiency and aortic regurgitation, with weak heart, and prefers it in most cases to Digitalis. He thinks it equal to Convallaria.
Hans Voigt, working in Nortengale’s clinic, has come to the following conclusions respecting the therapeutic action of Sulphate of Sparteine: In small doses the salt increases the efficiency of the cardiac contractions and raises the arterial pressure. The number of heart-beats are always increased. These effects are observed within an hour of the administration of the drug, and continue for twenty-four hours. The author recommends the suspension of the administration of the drug for some days, but it may be given for a week without risk. The remedy does not always regulate the rhythm of the heart-beats. Its action on the respiration is variable. Diuresis appears to take place in proportion to the improvement of the cardiac action. A beneficial sedative action is often observed. Headache, vertigo, malaise and other objectionable symptoms were but rarely met with as the result of administration of small doses. The dose employed has been from 1 to 4 milligrammes (15/100 to 6/100 gr.) It will be remembered that in See’s hands much larger doses, 5 to 20 centigrammes (3/10 to 3 gr.), were tolerated without cumulative or other objectionable effects.
My own experience with Sparteine has been limited to a few cases of mitral insufficiency when Convallaria was not well borne, and Adonis caused gastric irritation. When it does act, it with promptness and certainty.
I usually prescribe the 2d trituration of the Sulphate to begin with, giving five to ten grains every three hours. If the desired effects do not appear in twelve hours, I give two grains of the 1st. So soon as the heartbeats have acquired more force and become slower, the frequency of the dose is lessened.
It does not regulate the rhythm of the pulse as well as Digitalis, but an arythmical pulse is often present where the heart is doing good work. I have had no experience with the tincture of Broom. In a few cases I have used the infusion, but the results were not satisfactory.
Dr. A. Maslowski (Russk. Medorrhinum, Nos. 11 and 13) has recently used Sulphate of Sparteine in three cases of cardiac diseases, which were as follows:
1. Pulmonary emphysema with bronchitis and chronic myocarditis.
2. Pulmonary emphysema with irritable heart.
3. Insufficiency of the aortic valves and aneurism of the aortic arch.
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.