His observations regarding the action of the drug (as prepared by E. Merc) have led him to the following conclusions:
1. Sparteine, when given in medium doses, excites the heart’s action, whereby its contraction becomes stronger and the pulse fuller. The rapidity of the pulse is generally somewhat decreased.
2. The action of the drug is very rapid. The rhythm of the impaired heart’s action is not entirely restored, although the contractions become considerably stronger.
3. The quantity of urine is greatly increased by the drug. Cumulative or unpleasant accompanying effects were never observed.
Voigt and Leo have, through recent papers, added to our information as to this alkaloid. According to the analysis of their papers, published in the Medorrhinum Chron. for April, 1887, Voigt found that Sparteine, in doses of 1/65 to 2/65 grain, in a series of cardiac and other diseases, stimulated the heart, increased the contractions, and raised the blood-pressure. It acts quickly, and its action lasts often over twenty-four hours, during which time the effect can be increased by a repeated dose.
A pause of a few days after continuous administration is useful, as the drug acts the more forcibly afterwards. He finds it to be a diuretic, but not one of first rank. Toxic symptoms, very seldom observed with doses of 1 to 4 mg. (1/65 to 4/65 grain), were faintness, headache, palpitation and uneasiness, which soon disappeared, even when the use of the drug was continued.
Voigt would recommend Sparteine for therapeutic use:
1. In valvular disease with failing compensation.
2. In valvular disease, without faulty compensation, as a tonic and sedative.
3. In weak action of the heart without valvular disease.
4. In pericarditis.
5. As an adjuvant to Digitalis.
Leo exhibited Sparteine in doses of 0.1 gm. (11/2 grains), every two hours, in twenty-four cases. In only nine of these was there any objective result definitely traceable. In the remaining fifteen cases, eight showed subjective improvement, and in seven no result whatever was perceptible. In the first nine cases there was marked diuresis. The drug did not influence the blood- pressure materially, and on this point the author differs from Germain See, who placed Digitalis and Sparteine side by side.
He ascribes the diuretic action of the drug to stimulation by it of the renal epithelium. He found the drug to have a marked action upon the heart in relieving palpitation, pain and dyspnoea. In the majority of cases where relief was afforded there was no evidence of any controlling of the heart’s action. He finds Sparteine most active when given shortly after a course of Digitalis. No symptoms of poisoning were observed.
The author thinks that Sparteine is indicated when diuresis is required, and will be principally useful in cases of cardiac disease with failing compensation. It is noteworthy that though Leo has administered the drug in doses a hundred times greater than those given by Voigt, yet he seems to have been less successful in his results.
Dr. J. Prior, Docent in Bonn, prompted by experiences of Germain See, has for some time past been using Sulphate of Sparteine as a heart remedy in general, but found it especially useful in affections of the cardiac muscles, be it either change of tissues or weakness; further, also, in valvular troubles when the compensation was affected, and particularly when the pulse was irregular, jerky or arythmic. The author sums up the results of his observations with the drug in the following notes:
1. Sparteine increases the secretion of urine. This, in healthy patients and under certain circumstances, may take place without the circulation being materially affected.
2. Whether, according to the views of H. Leo, Sparteine owes its diuretic property to its effect on the epithelium of the kidneys or not has not yet been proved. It is, however, very possible that the effect the drug has on the heart’s action increases he quantity of urine, as the author’s experiments have proved to him beyond all doubt that Sparteine Sulphate materially affects the pressure of the blood.
3. It must also be mentioned that, although Sparteine had a beneficial effect on almost every heart trouble, yet in several cases it had no apparent effect whatever. It acted best when used in cases of irregular compensation, which resulted from valvular affections.
4. The drug usually commences to act in about two or three hours after it has been administered, and the effects last for a few hours, but in some cases even for as long as three days.
5. If the remedy has overcome the irregularity of compensation, it will keep the heart’s action regular for some time, as is shown in notes 12 and 13.
6. In patients where the secretion of urine has been suppressed by the affection of the heart’s action, the drug will perform the double duty of regulating the heart’s action, and at the same time increase the secretion of urine; the oedema and the serous transudations will also disappear.
7. The pulse frequency will be lessened, which is explained by the heart’s action having been regulated, and the pressure of blood increases.
8. It will be well to mention that also in those cases where Sparteine has no apparent effect on the heart’s action and has failed to regulate it, yet the pressure and difficulty in breathing were always relieved.
9. No beneficial effects were observed from the drug when used in cases of bronchial asthma.
10. On one occasion only were evil after-effects observed to follow its use, and that was after a dose of 2 grammes (31 grains). The pulse once became irregular. This was the only case when any disagreeable effects were noticed. Above all, the drug seems to have no injurious or irritating effect on the stomach or bowels.
11. Concerning the size of the dose which is necessary to insure the action of Sparteine, it was found that doses of 0.2 (about 1/3 grain) per dose and 11/2 grains per die, which, by Voigt, are called “medium doses,” were too small. A far better action was observed when, from the very outset, doses of 1 decigramme (11/2 grains) were given, and in some peculiar cases even as much as 2 decigrammes (33/4 grains) at a dose, and in a few special cases this dose was repeated several times during the day. In this respect the author agrees with Germain See and also with H. Leo, who both advise 1 dose (11/2 grains) several times a day, and who ordered 2 or more grammes of Sparteine Sulphate to be taken in two or three days. Larger doses than this should, however, be used with the greatest possible caution, as it has been observed that when over a certain amount has been given the action of the drug was reversed, and caused a still greater irregularity of the heart’s action than that which had existed before the drug was used. From this fact it was, however, seen that
12. This artificial irregularity ceases in eight to twelve hours, and the former state again supervenes; and now smaller doses of the drug may be given with the same effect as though the drug had never been used before. From this it may be justly inferred that
13. No accumulative effects of Sparteine need be feared.
The author considered the use of the drug indicated in all cases of heart trouble in which Digitalis, which is still the reigning cardiac remedy, has been tried without avail, or when, from some reason or other, its use is abstained from, or when it is desired to regulate the heart’s action in the least possible time.
Furthermore, the use of Sparteine is of great value in stenocardiac attacks. It will give relief and good results, even when the heart’s action is seemingly unaffected by it.
Its diuretic action is also of great value. The author is still in doubt as to its accredited action in bronchial asthma, but, at any rate, it cannot be compared with other remedies which are used in that disease.
Levascheff has undertaken a series of studies with the object of determining whether Sparteine acts on the contractions of the heart, and if so, in what manner that action is produced – whether it is diuretic, if it acts favorably in cases of insufficiency in the contractions of the heart, in renal dropsies, and in the dropsies produced by hepatic cirrhosis. Finally, he compares Sparteine to the other cardiac diuretic remedies. Professor Levascheff formulates his conclusions as follows:
First – The Sulphate of Sparteine has incontestably the property of reinforcing and regulating the contractions of a feeble or arythmic heart, while at the same time slowing the pulse, if that should accelerated.
Second. – Sparteine increases the blood-pressure, and causes the disappearance of symptoms of blood-stasis and oedema, thus acting favorably on diuresis. The respiratory movements, under the influence of this remedy, become slower and more regular.
Third. – Clinical studies have not yet determined a diuretic action for Sparteine, and it is not yet known as to whether it possesses any direct action on the renal epithelium.
Fourth. – Sparteine is less active than the other cardiac tonics – Digitalis, Adonis and Strophanthus.
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.