Fifth. – In inveterate cases, where the heart-muscle shows symptoms of degeneration, or where oedema is very excessive, Sparteine is without effect, even although the other cardiac remedies may act in a more or less favorable manner.
Sixth. – Sparteine is indicated in recent cardiac affections, when compensation is but little disturbed and when the degeneration of the cardiac muscle is inconsiderable.
Seventh. – Sulphate of Sparteine has a decided and yet not transient action on the heart, but this action is too feeble to produce well-pronounced therapeutic effects.
Eighth. – Sparteine acts very rapidly, fifteen minutes being sufficient to produce its characteristic action.
Ninth. – Thanks to this rapidity of action, Sparteine has a certain value in cases of acute enfeeblement of the action of the heart, as is often observed in different infectious diseases.
Tenth. – Small quantities of Sparteine (three-fourths of a grain daily) produced a therapeutic effect, but pronounced and constant action is not procured with doses smaller than from two to five grains daily. Larger doses do not produce more marked effects.
Eleventh. – The daily dose of Sulphate of Sparteine should be from three-fourths of a grain to five grains, taken in three or four doses.
Twelfth. – The inconveniences of Sparteine are irritation of the mucous membrane of the intestines, and, as a consequence, diarrhoea, vomiting and nausea.
Panniskie also reports the result of thirty-three observations of the clinical employment of Sparteine, and he summarizes his results as to the action of Sparteine on the heart as follows:
1. Nervous troubles of the heart.
2. In cases of painful and distressing sensations in valvular diseases of the heart.
3. At the commencement of Graves’ disease.
4. In the asthmatic attacks of bronchitis and emphysematous subjects.
5. In cases where Digitalis is not supported.
SPIGELIA.
There are about thirty known species of Spigelia, natives of tropical and sub-tropical America. Spigelia Marylandica is indigenous to our Southern States; spigelia anthelmia is a native of Jamaica and some other West Indian islands, Spigelia glabrata grows under the equator. The more tropical the species, the more poisonous they are. They all cause similar symptoms, varying only in intensity, and there is no necessity for separating them. In the foreign markets the various species are mixed when sold. An American physician, Dr. Lining, wrote of it first, in 1754. He claimed to derive his knowledge of its uses from the aborigines. Then followed Drs. Garden, Chalmers, Barton, Ives, Thompson, Eberle, Dewees, Wright and others, all Americans. It was introduced into Europe and came to the knowledge of Hahnemann, who, with his rare intuition, foresaw its great and varied powers, which he illustrated by his heroic provings.
At first it was used solely as an anthelmintic, and even to this day is so used by many regular physicians. Dr. Wright first pointed out its narcotic properties, Barton reported cases of death from its employment, and Chapman attributed its efficacy as a vermifuge to its narcotic influence on the intestinal parasites. Ives explained that it first stupefied, then expelled the worms by its purgative influence. He compared the effects of the fresh root with those of Digitalis and Stramonium. “Like the former,” he says, “it quiets general nervous irritation, and, like the latter, it caused dilatation of the pupils.” But, when this was written, very little was really known of the real action of Digitalis. Ives says Spigelia causes a sort of mental derangement, with alternate fits of laughing and crying. Thompson took large doses of the root and found it produced acceleration of the pulse, flushed face, drowsiness and stiffness of the eyelids.
A case was reported in 1855 by Salisbury, in the Boston Medical and Surgical Journal, where an infusion of three drachms of the root, in three gills of boiling water, was ordered for a child, 4 years of age, to be taken in eight equal doses at intervals of two hours. After the third dose the skin became hot and dry, the pulse 110 and irregular, the face, especially about the eyes, including the lids, much swollen, and the pupils widely dilated. There were strabismus of the right eye and a wild staring expression, giving the countenance a very singular and, in fact, ludicrous appearance. Yet the intellect seemed unaffected. On attempting to assume the erect posture the patient was seized with general tremor, which passed off in a few seconds, and left her quite exhausted. The next morning all the alarming symptoms, with the tumefaction of the eyelids, had disappeared. Dewees declares it is harmless, and that he has never seen distressing symptoms from its use, but adds that it did, in a few cases, cause “slight squinting, with delirium.” We should think these ominous symptoms were distressing enough.
The universal testimony of the old school as to its effect as a vermifuge allows no doubt of its powers.
19 When given in the doses they prescribe, it doubtless does narcotize the worms. But it is a singular fact relating to worm medicines that they often remove so-called “worm symptoms” when there are no worms. This is true of Cina, Granatum, Santonine, Chenopodium and others. Dr. Stille, one of the most acute of observers, alludes to these when writing of Spigelia. He says: “There is a state of intestinal derangement presenting all the symptoms of lumbricoid ascarides and which is most frequently observed among strumous, feeble and precocious children. They have fever, a dry, hot skin, furred tongue, tumid and confined bowels, capricious appetite and nervous irritability. These symptoms are often dissipated by Spigelia, without causing the discharge of any worms.” An English physician recently asserts the same of Pomegranate bark.
Now, there are two explanations of this. 1. The worms may really exist, are killed by the drug, and are digested. Living worms are not affected by the gastric juices, but, dead, they are seized upon and treated like any piece of meat. 2. Provings of all the anthelmintics show them capable of causing all the so-called “worm symptoms.” This they do by acting as irritants to the intestinal tract, and arousing reflex irritation as well as a direct irritant action on the brain and spinal cord. They are, therefore, all homoeopathic to “worm symptoms,” whether caused by parasites or other irritants in the intestinal canal.
Spigelia causes certain brain and heart symptoms, caused by no other drug, but even these are simulated by the irritant action of intestinal parasites. Notwithstanding the neurotic effects of Spigelia observed by their own school, the regulars have never applied this drug to other than worm affections. Hahnemann’s provings and his use of it have always been a terra incognita to them. They have ignored its action on the eyes, the cranial nerves and the heart. In our school it is an invaluable remedy for certain neuroses affecting the head, eyes and heart. We have used it successfully in rheumatism, which is believed by many pathologists to be a neurotic disease. Hughes, in his Pharmacodynamics, has given such a concise yet clear resume of its curative sphere that I will not repeat it. In Allen’s Encyclopedia of Materia Medica you can find all the symptoms of this potent drug. Fortunately, Hahnemann’s provings were made with massive doses of the tincture, so that we cannot doubt their value. These, with the cases of poisoning above mentioned, have given us a good pathogenesis. Added to these, we have now some later and important knowledge of the power of this drug. It comes from Allopathic sources, and I am sorry to say that, while our school seems to be neglecting heroic drugs and physiological experiments, the Allopaths are making rapid progress in that direction.
Dr. H.A. Hare, in the Medical News, of March 12th, 1887, gives us the following results of physiological experiments with Spigelia: “When as much as three ounces of the fluid extract of Spigelia are given by stomach to a large dog, weighing forty pounds, the following symptoms appear: Almost immediately after the ingestion of the dose the animal has short and quick expiratory movements, amounting almost to a cough; soon after the pupils become widely dilated, and at the same time a very marked internal strabismus asserts itself, the eyes becoming fixed in this position, so that they cannot follow any object, such as a pencil, when it is passed from side to side. Constant retching, with no result, now comes on, the animal standing, and apparently suffering from no sensory or motor palsy. There is a change in gait soon after this marked exophthalmus develops itself. The retching, having lasted about five minutes, now passes off, and at this time signs of muscular weakness and lack of co-ordination appear; the walk becomes staggering in both fore and hind legs. The respirations now become very rapid, resembling those of a dog after a long, hot run; the tongue hangs from the mouth and is dry and red, and the nose is hot and no longer moist. Muscular power is progressively lost, so that the dog falls frequently when endeavoring to walk, but sensation does not seem to be affected. About this period the animal lies down and passes into deep sleep, which in time passes into coma, and death follows without any movements being made, evidently from a general failure of vital force. The respiration, as death approaches, becomes slow, and is finally extinguished consentaneously with cardiac arrest. In the frog the same symptoms occur as in the higher animal, including the marked exophthalmus and, to a less degree, the strabismus. The fixation of the eyeball is extreme, and it feels to the finger like a hard knob which the lid cannot cover. Muscular weakness, with dropping of the jaw, comes on, and motor power is constantly decreased, until the patient lies relaxed and powerless. That the action of the drug in thus destroying motor power is spinal was proved by the following experiments: If the hind legs are protected from the poison by ligation of the abdominal aorta, the palsy is as great as under ordinary circumstances, and reflexes are totally abolished. Further, if the spinal cord be directly galvanized, no movements occur in the hind legs; and, lastly, if Strychnine be injected into the body, even in large amount, its action is not only slight, but occurs after the lapse of many minutes. That the drug has no action on the motor nerves is proved by the fact that, when the poison reaches the efferent nerves, either through the circulation or when directly implied, galvanization of the nerve-trunks causes normal contractions in the tributary muscles, and the sensory nerves likewise escape; for if the drug be applied directly to the nerve and the foot irritated, signs of pain are elicited, and reflex movements occur. Further than this, if the vein in the leg be tied and the drug injected into the limb, thus protecting the spinal cord, reflexes occur on irritation of the drugged foot. That the palsy is not cerebral is proved by the fact that movements of muscles supplied by the cranial nerve continue long after the movements in the legs have ceased, and by the other experiments already detailed. The action of the drug on the circulation is as marked as its effects on the nervous system, and on the cardiac muscle it acts as a direct depressant poison, for if it be injected into the jugular vein in such a way as to coma suddenly in direct contact with the heart, the movements of that viscus almost instantly cease. Further than this, if the excited heart of the frog is dropped into a strong solution of the drug, its movements are almost immediately stopped in a condition of diastolic arrest, although the relaxation is not very marked.
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.