MATERIA MEDICA OF HEART REMEDIES



Pharmaceutical Preparations. – Parke, Davis & Co., of Detroit, prepare two fluid extracts, one from the root and the other from the flowers. In either case the strength of the preparation is a pound of the drug to a pint of the finished fluid extract, and the process used is maceration in a menstruum of fifty per cent. alcohol with subsequent expression by means of powerful hydraulic pressure.

The dose of the fluid extract of the root or of the flowers is from five to fifteen minims, to be gradually increased until the desired effect is produced. Probably all Homoeopathic pharmacies have now prepared special tinctures of this plant, when it is in bloom, and only fresh flowers should be used.

Nearly two years ago, when the information relating to the virtues of the plant became known, I procured a quantity of the fresh root and prepared a tincture, using strong alcohol. I gave some of the root to Gross & Delbridge, of Chicago, who prepared from it a tincture. I have had ample opportunities to test this preparation, but I have never been able to get satisfactory remedial effects. I have tried Parke, Davis & Co.’s fluid extract of the root with no better success. This surprised me, as it is generally supposed that the roots of a plant must possess the properties of the plant.

I next tested the fluid extract of Parke, Davis & Co., which, they assert, is prepared from the flowers, and from this preparation I have always received good reports, and have seen the most prompt and decided remedial effects. The Homoeopathic tincture can be 1/4 the strength of this fluid extract. It should be made from the fresh flowers 3iv to one pint of diluted alcohol.

Prof. Germain, of Paris, has found the aqueous extract of the plant to be the most active preparation. A concentrated solution dropped upon the heart of a frog speedily arrested its action in systole. The same prompt effect was observed in warm-blooded animals.

Employed in actual practice, the aqueous extract was found to act first as a strong diuretic, surpassing Digitalis in this respect. And it has this advantage over the latter, that it does not injuriously affect either the digestive or the cerebro-spinal system.

Botkin recommends two-third parts of a tincture made from the flower and stems and one-third part of the tincture of the root be mixed. Given in doses of 1 gramme (15 grains) of the aqueous extract to 11/2 grammes (22 grains) daily, it produced very favorable results in cardiac diseases. Up to the present no precise statement of dose has been made with respect to convallamarin, which is evidently the active principle in the extract.

Convallarin does not appear to be of any value. The effects on the system of the two principles of the plant have been investigated by Dr. H. Marme, of Germany, with the following results: Convallarin, in doses of three or four grains, acts as a purgative, without observable inconvenience to the animals acted on; Convallamarin, even in small doses, produces active vomiting, whether given by the mouth or injected into the subcutaneous tissue, or directly into the veins. The latter principle acts especially on the heart, at first diminishing the number of its pulsations, and afterwards rendering them more frequent and causing death in a few minutes after the introduction of the poison. The heart appears to be paralyzed and cannot be excited after death. The principle acts on the heart through the vagi nerves, and resembles Digitalis in its mode of operation. From six to eight milligrammes caused death when injected into the cervical vein in rabbits, and 15 to 20 in dogs (Schmidt’s Jahrbuch, 1867, v. 166).

The powder made from the flowers when dry has long been employed as a sternutatory, its effects being to excite a copious flow of tears and nasal mucus. The root and flowers possess purgative properties, as does also an extract made from the former. Its mode of purgation has been compared to that of aloes and of scammony. The dried flowers have been used to prepare fomentations for the removal of ecchymoses and bruises, and, as well as the root, for the cure of worms, intermittent fever, and even epilepsy.

Dr. Alfavef, military surgeon in the caucasus, writes: “The plants grow plentifully there in the mountains, and have a great reputation among the people as a remedy for intermittent fever. The doctor experimented systematically on thirty-eight typical cases of that fever, but with only indifferent success. The plant will, therefore, never rank among the remedies for this disease, but the experiments are very interesting from the fact that they throw a great deal of light on the mode of action, dose, etc., of this potent remedy, which we here produce, in short. According to popular precedent, the experiments were made with the flowers only, leaving it an open question whether the therapeutic effect of the root and stem is identical with that of the flower.”

The alcoholic tincture was found to be the most convenient, as well as the most potent form of the drug. The tincture used was of the strength of four ounces of the flowers to the pint of dilute alcohol. In its mode of action it is very peculiar. When twenty or thirty-drop doses were given the pulse became slower and less compressible. No unpleasant effects were noticeable, although the doses were finally increased to half a fluid ounce each. The results of these experiments as concerning the pulse, in substance, are expressed by Dr. A. as follows: “In small doses (five to ten grains of the powdered flowers, equal to 20 or 30 drops of the tincture), the remedy invigorates the pulse much more noticeably than in large doses (one drachm of the powder, or one-half fluid ounce of the tincture).

“Large doses seem to act simply as regulators of the pulse, no matter what was its preceding state. As to the diuretic effects of the remedy, I have observed that while small doses had a well- marked influence in that direction, this influence was not increased from larger doses. For instance, the following case: Simultaneously with tertian intermittent, a patient was suffering with acute hydraemia, general dropsy and stasis of blood in the lungs, the pulse being 120 and weak. He was ordered to take tincture convallaria, 20 drops, twice a day. No other remedy was used. In five days his condition was much improved; the pulse became stronger, the breathing freer, the quantity of urine had increased fourfold; but the intermittence showed no symptoms of abatement, the paroxysms being even more severe than before.

“I am, therefore, inclined to think that the Convallaria acts as a diuretic only as it stimulates the heart’s action, and consequently increases lateral blood-pressure, being similar in this respect to Digitalis. But its great advantage over Digitalis is that it is quite harmless, even in overdoses.

“I have also tried the Convallaria (in small doses) in pneumonia, and once in a case of dropsy from fatty degeneration of the heart, and obtained a slowing of the pulse, and, in the latter case, an increase in the quantity of urine voided. I think it therefore likely that the Convallaria may with advantage be substituted for Digitalis, wherever the latter is indicated.”

Ralph D’Ary, M.D., Romeo, Mich., writes: “I have used the remedy somewhat indiscriminately in every variety of heart disease coming under my hands, both functional and organic, with a view of testing its efficiency in the various forms of these affections, and nearly in every instance with most gratifying results. In fact I have not been able to determine any special indications (or contraindications) for its use – its effect seems so uniformly beneficial. It certainly had not the least direct restorative value, in my hands, in organic disease; not any more than Cactus grandiflorus, for which such claims have lately been set up by some enthusiastic practitioners, mostly of the Homoeopathic persuasion. But although Convallaria is unable to alter the organic status praesens, it enables the patient to make the best of it by compelling nature to put her best foot foremost. It is pre-eminently a regulator of nervous function, adapting the latter to existing conditions in such a manner as to compensate to the utmost possibility for the existing organic lesion. The sympathetic nervous system seems especially to be under its control, though it is by no means devoid of a powerful influence on the cerebro-spinal system. This circumstance accounts for its almost universal adaptability, in varying doses, to every variety of heart disease. In small doses it is a stimulant to the heart, increasing the frequency of its beats; in larger doses it is a tonic and sedative, lessening the frequency, but increasing the energy and regularity of the contractions. In overdoses it is a swift destroyer of life, thoroughly paralyzing the heart. Over Digitalis it has a most important advantage in the absence of a cumulative effect, at least so far as personal observations allow me to judge. On the other hand, I have noticed that some patients seem, from idiosyncrasy, unable to endure it even in small doses. Wherever these unpleasant effects – manifested by dyspnoea, faintness, pain at the heart, etc. – become manifest, alcoholic liquors seem to me the promptest antidote. I would, therefore, strongly advise, in every new case, to begin with minimum doses and gradually increase until the desired effect is obtained, which generally takes place very promptly. It is an excellent nervine sedative tonic, especially where the patient suffers from the consequences of excessive reflex irritability or ‘nervousness.’ Thus I have found it useful in certain conditions of insomnia, hysteria, the restlessness of fevers, infantile nervous disorders caused by the irritation of dentition, etc. In tic-douloreux and neuralgia in general it has sometimes acted with great promptness. It is not a narcotic or anodyne simply, and therefore does not merely lull the pain by stupefying the patient’s sensibility, but seems to act as a direct nerve tonic and sedative, restoring the equilibrium of nervous function. You will see, therefore, that it opens up a wide field for further careful investigation. In using it the practitioner should always bear in mind that in this connection the old adage may well be reserved, and should be remembered as magis remedium, magis venenum. But although it requires care in its employment, I believe the Convallaria to be a safer remedy than Digitalis, in its cardiac sphere, especially in desperate cases where large doses are imperative. What practitioner of any experience has not found himself once in a while in a responsible position where he had to choose between the almost certain death of his patient and another, and yet another, heroic dose of Digitalis, and yet had no means of ascertaining whether the preceding doses had finally expended their effect, or were only waiting the re-enforcement of another dose in order, with combined power, to extinguish the last remnant of cardiac life? How often is the last dose of the potent but treacherous remedy but the messenger of death! Herein lies the special value of Convallaria – once its effect is expended apparently, it is so in reality, and another dose may be safely administered. Such is my experience, but as the point is one of so much importance, more than one or two men’s observations should be recorded before it should be accepted as a fully-determined fact.”

Edwin Hale
Edwin Moses Hale 1829 – 1899 was an orthodox doctor who converted to homeopathy graduated at the Cleveland Homoeopathic Medical College to become Professor Emeritus of Materia Medica and Therapeutics at Hahnemann Medical College, editor of the North American Journal of Homeopathy and The American Homeopathic Observer and a member of the American Institute of Homeopathy. Hale was also a member of The Chicago Literary Club.

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.