Dr. S.C Cherr, after giving in detail a case of cardiac dropsy which terminated fatally, concludes as follows: “Since my first use of Strophanthus in this case I have employed it in others similar in character. I have also used it as a cardiac tonic in other cases of weak heart, without valvular or other discoverable organic disease. In one case of double pneumonia, now convalescent, in which there was great danger from extreme feebleness and intermittence of the heart, it has been manifestly beneficial. Indeed, it has seemed to me to produce some good effect always in such conditions in the way of increasing the contractile powers of the heart. But in no case has its efficacy been more conspicuous than it was in the one I have reported, in which, nevertheless, the amount of disease was necessarily fatal. That any response to a medicine should have been made under such circumstances, or any improvement have occurred, was remarkable; and yet, over and over again, in this advanced stage of disease, the most unmistakable benefit was wrought by the Strophanthus.”
Dr. J. Hutchinson, Glasgow, has used Strophanthus with good results in cases in which the prominent symptoms were cough, dyspnoea, palpitation and oedema of feet and legs. In seven cases the palpitation seemed to be dependent upon dyspepsia; remedies were given for that condition; Strophanthus was also used in the hope of its exerting a calming and steadying influence upon the heart, which in all of them it succeeded in doing. The dose is from one to ten minims of the (1/20) tincture, equal to one of the 1/20 grain to two of the 1/4 grain McK. 8R. granules. The therapeutical and physiological effects of Strophanthus were brought before the notice of the K.K. Gesellschaft der Aerzte of Vienna, on April 29th, by Professor Drasche. He reports that in his hands, and in those of Professor Bamberger, it had fully satisfied the expectorations raised regarding it, and that it was already finding its way among the private practitioners of the Austrian capital. He had not hitherto used the full dose recommended by Fraser, in fact only the half of it, but in future he would give the quantity prescribed by its introducer. The pulse-rate invariably fell after its administration – sometimes in a few minutes, sometimes in the course of half an hour – and continued slower for several hours. In a typhoid case the pulse was kept at 52 for fully eight days. One patient complained of muscular weakness after a dose, so that she could scarcely sit up. In the case of a nervous patient, with a pulse of 140 to 150, ten minims, three times a day, reduced the rate to 120 beats. This action was still constant, and it took place almost immediately. In a case of Basedow’s, (Gravis) disease with tumultuous cardiac action, twenty drops of the tincture effected improvement, and the arythmia present was also somewhat improved. He had treated thirty cases of actual disease of the heart with the drug, and he must confess that he was quite contented with its action. Exaggerated cardiac action was reduced more quickly and surely than by either Digitalis or Adonis.
Professor Drasche (Wien Medorrhinum Blatter, 1887, page 586) found five drops of the tincture of Strophanthus given to the healthy man would produce in about three hours a fall of from about 8 to 12 beats per minute of the pulse, which would last part of the day. After ten drops the pulse fell in half an hour 12 to 20 beats; after twenty drops the pulse sank, in the single case given, from 84 to 54 strokes. There was no influence on the respiration, but a lowering of the temperature; in some cases as much as a degree. Fifteen drops given hypodermically caused great irritation and pain and swelling at the place of injection, violent headache, repeated vomiting and nausea and copious secretion of urine; the pulse fell in an hour form 96 to 84, and the next day the headache and general ill feeling continued, with a pronounced local irritation. In a strong 45-year-old man, suffering from left-sided-pneumonia, four doses a day of five drops of tincture of Strophanthus were followed in twenty-four hours by a fall of the pulse 18 beats per minute, and by a distinct slowing of the respiration and reduction of the temperature 0.8 degree C. The pneumonia itself was not affected, and the crisis came on the ninth day. In another similar case, the influence of the Strophanthus, the pulse fell from 128 to 88 beats. In acute phthisis the remedy acted very promptly; there was high fever, with the pulse ranging from 140 to 152; five minutes after the exhibition of ten drops the pulse fell 20 beats, and two hours later 40 beats, while the temperature had gone down between one and two degrees, and the distressing cardiac palpitation was relieved. The rapidity of the action of Strophanthus showed itself also in a case of gastro-duodenal icterus. In twenty minutes after the use of twenty drops the pulse had fallen from 72 to 60, and the blood-pressure, as measured in a temporal artery, had increased ten per cent. According to Professor Drasche, forty to fifty drops a day must be considered as the maximum dose of the tincture. Under sixty drops a day, in an experimental case, the pulse became exceedingly small, weak and irregular. In a case of vaso-motor neurasthenia, with a great rapidity of the pulse, the continued use of the medicine was kept up, with interruptions, until 600 drops of the tincture had been taken without the production of any evidences of cumulative action.
Professor Drasche has also used the remedy in a number of cases of heart disease. In one case a 36-year-old patient with fatty heart and very pronounced cardiac symptoms, ten drops of Strophanthus tincture produced great relief of palpitations and of the dyspnoea. One hundred and sixty drops were taken in the course of five days without the slightest evil influence. In a second very advanced case, in which there were dropsy, very pronounced dyspnoea and very irregular pulse (120), in which Digitalis had failed, five drops of the tincture every two hours, until thirty drops had been taken, caused the pulse to fall to 108 without becoming more regular, but shortly afterward the patient fell into a stupor and four days later died. In another similar case, forty drops of the tincture a day were followed by marked fall of the pulse and increase of the urine. Strophanthin was later given in solution, the four doses each day amounting to two milligrammes. The pulse became very irregular, varying from 36 to 60 beats every minute. There were marked increase in urinary secretion and great lessening of the dyspnoea. In a case of aortic insufficiency, which came into the hospital almost moribund, with the pulse 96, scarcely to be felt, fifteen drops in an hour caused the pulse to fall to 72 and become much stronger, and the patient slept through the night, for the first in three months. Afterwards forty drops of Strophanthus tincture being given daily, the pulse fell to 60; but the patient complained of so much burning in the oesophagus and stomach with nausea that the medicine was withdrawn and Digitalis substituted. It, however, failed to have influence, and the man shortly afterwards died suddenly. In a second case of aortic insufficiency, the tincture of Strophanthus was given for four weeks regularly, forty drops a day, with great relief to the dyspnoea. Besides these cases, Dr. Drasche reports several others in which the Strophanthus tincture produced results similar to those that have been just described. The effect upon the excretion of urine seems to have been most extraordinary. In some instances the amount excreted after the administration of the drug, was five, or even six times what it had been before. Almost universally when the Strophanthus was pushed the patient complained of burning in the oesophagus and stomach, with loss of appetite and extreme gastric distress, which not rarely rose to vomiting; sometimes there was diarrhoea. In no case was there any evidence whatever of cumulative action. The action of the drug is not only more prompt in coming on, but is evidently less permanent than is that of Digitalis. Dr. Drasche also tried using the remedy in cases of mitral insufficiency; here the effect of the remedy was often more marked than in cases of aortic disease. In one old case, with bloody sputum and other very severe symptoms, twenty-five drops a day of the Strophanthus tincture had so favorable a result that on the eight day the patient left the hospital. In a case of mitral stenosis, with very severe symptoms and great cyanosis, after a second dose of forty-five drops of the tincture, the pulse became strong at the rate of 44 beats, the respiration 16, and the urine enormously increased. This patient took in all 360 drops of the tincture without any untoward symptoms, but with the most favorable results, the patient leaving the hospital greatly relieved. Other cases of mitral diseases were affected similarly. As the result of his observations, Professor Drasche thinks that while we must consider Digitalis to act more as a tonic agent upon the heart, Strophanthus must be looked upon rather as a cardiac stimulant. He is also particular in cautioning a physician to see that the preparation used is genuine and pure. Strophanthin he believes to fully represent the tincture. As a diuretic, he gives the daily dose of Strophanthus as three miligrammes, and, for reasons which we have already laid before our readers, condemns its use hypodermically.
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.