In most cases of active congestion the vaso-motor constrictors prevent undue distension of the cerebral arteries. It is when they fail in restraining power that Belladonna should be given to aid the heart restraining power of Veratrum or Aconite.
Chronic hyperaemia of the brain is often kept up by an irritable heart, from functional irritation of cardiac ganglia or muscular hypertrophy of that organ. Here, in order to relieve the oppressed brain, we must quiet and restrain the heart by the use of Aconite, Gelsemium or Belladonna.
Directly opposite in its results is the effect of a weak and irritable heart. Its propelling power is below normal. It does not fill the cerebral arteries, and a condition of cerebral irritation obtains.
Delirium tremens, the delirium of typhoid fever, and certain forms of insanity depend on a weakened heart. An extreme degree of cardiac debility causes coma, dementia and that peculiar condition called the hydrocephaloid state. Even in true hydrocephalus, we find the former condition. In such cases cerebral remedies are useless. We must increase the working power of the heart by food and stimuli, aided by cardiac tonics.
Of these Digitalis, Phosphate of Strychnia and Phosphorus are the most important.
Case I. A child, 9 years of age, had an attack of acute hydrocephalus, which was treated with Belladonna and Helleborus. But the stomach was so irritable that scarcely any food was retained for two weeks. Feeding per rectum was rendered futile by paralysis of the sphincter. Only during the third week was food retained, but instead of convalescence a semi-comatose condition set in. The heart’s action was very feeble, irregular and intermitting, and the surface of the body pale and cold. In this case the administration of Digitalis and Iron in small doses induced a rapid change for the better and a quick recovery.
Case II.- A man, aged 55, had a run of sewer-gas fever, lasting six weeks, under regular treatment. The friends became dissatisfied, and placed me in charge of the case. There was no fever, but complete paresis. He could not see across the room; all objects appeared in a fog. He could speak only in a low whisper. He was deaf, and had lost the sense of taste. He lay all day motionless, except when turned over by his nurse. There was general anaesthesia. He passed urine involuntarily, and his bowels had not moved for a week. He had been filled with Quinine and Iron, beef-tea and eggnog, given to repletion.
The heart-sounds could scarcely be heard, its beats very irregular, the pulse scarcely perceptible, yet under the use of an acid solution of Phosphate of Strychnine and Digitalis he made a rapid recovery.
In that excessive anaemia of the brain, which obtains in mania a potu, when anodynes, sedatives and the stimulus of food fail to calm the patient and cause sleep, Digitalis in potent doses will change the condition like magic, by causing calm and slower beating of the heart, enabling it to feed the starving brain with blood. In the treatment of sleeplessness from mental overwork, in persons of weak and dilated heart, a few drops of Digitalis, Convallaria, or Veratrum album will have a better effect than all the anodynes in the pharmacopoeia. In old persons with a tendency to apoplexy, especially when the arteries are rigid and brittle, the condition of the heart should be closely watched. As the arteries grow smaller and more atheromatous, the blood-pressure increases to an enormous extent. The heart beats with phenomenal force, and unless it is soon subdued rupture of a cerebral artery and extravasation will surely occur. The remedy in such cases is Veratrum viride. It acts with a celerity which will astonish those not accustomed to use it. But it must be given in large doses. Five drops every half hour are none too much. Suspend the medicine as soon as the heart beats normally. I have never seen the slightest unpleasant effects from such doses, and I am sure I have often averted apoplectic attacks.
An opposite condition, once called “serous apoplexy” now known as senile anaemia of the brain is caused by a condition of the heart known as senile degeneration a kind of fatty degeneration. So long as a sufficient number of muscular fibre remains unchanged, the attacks of coma and dementia can be warded off by Digitalis and Arnica, for Arnica is one of the best cardiac tonics we possess in such conditions.
THE LUNGS.
are so closely connected with the heart that any deviation of the latter from a normal state will surely create an abnormal condition in the former.
Arterial congestion of the lungs attends cardiac excitement or inflammation of the heart. In the quick-acting, irritable heart, when the pulse is 100 or more, and hard without fever, the lungs are congested. It is this condition which precedes or attends phthisis pulmonalis. In true cardiac hypertrophy there is a constant congestion of the lungs. In both conditions pulmonary haemorrhage and inflammation may occur from slight exciting causes.
In order to prevent or arrest such attacks, the heart must be treated by medicines which modify its abnormal action. Aconite and Veratrum viride are the two chief agents. It does not require the presence of febrile temperature to indicate them. We must use them in such doses as will cause the heart to resume its normal rate and force.
Cactus, Lycopus, Adonis, Convallaria and Oleander may be indicated. But the efficient remedy must be one which depresses the action of the heart.
When death occurs in pneumonia, it is generally from heart- failure. The aim of the physician is, after the first or inflammatory stage is passed, to sustain the weakened heart by appropriate food and stimulants.
But food and alcohol are not all that is needed. Some direct medical tonic must be used, among which none are so potent as Digitalis. Under its influence, in proper doses, the failing heart slows its rapid feeble beating. The heart-muscles make a more ample sweep and throw the life current to the famishing lungs, hastening resolution, and preventing collapse. Aided by Phosphorus and Strychnia to strengthen the respiratory muscles, the patient recovers.
There are cases when heart-failure comes on suddenly; when the half-paralyzed heart struggles with the congealing blood in its cavities; the pulse is imperceptible, and a cold sweat covers the body.
There is not time for Alcohol or Digitalis to act. Then we must hasten to administer that most potent remedy, Glonoin. A drop of the tincture the 1/100 of a grain is placed upon the tongue, and in four or five minutes the heart rallies. Then give Digitalis or Caffeine and watch, lest the action of Glonoin ceases before that of Digitalis begins. Fifteen or twenty drops of Digitalis or five grains of Caffeine are none too large a dose in such cases of imminent danger.
THE LIVER.
When the heart supplies the liver with blood in sufficient quantity, the bile is secreted in normal amount. But in fevers attended with greatly increased action of the heart and in concentric hypertrophy, that organ becomes the seat of active congestion. The first result of such congestion is to cause an increased flow of bile. This is one cause of the bilious diarrhoea in children and adults. The hot blood forced into the liver acts like a drug stimulant. Aconite generally relieves this condition by lowering the action of the heart.
Passive congestion is more common, and is generally caused by some mechanical impediment to the return of blood through the veins to the heart. Example of congestion arising from this cause are most frequently met with in persons with organic diseases of the valves of the left side of the heart. In such persons it often happen that when the circulation becomes much impeded the liver grows larger, so that its edge can be felt two or three inches below the false ribs. The turgid state of the capillary vessels in the lobular substance of the liver and the slowness of the current through them impede, however, the secretion of bile, so that it often happens that after a few days these symptoms are succeeded by a sallowness of complexion which, in some cases, passes into decided jaundice. Not only do we find organic diseases of the heart causing jaundice, but a weakened heart from any cause will have the same effect. Now in such cases neither the congestion, enlargement nor jaundice can be removed by hepatic medicines alone. They may temporarily restore the secretion of bile, but a cardiac medicine must be given to effect a cure.
In any and every case of congestion of the liver and jaundice, always examine the state of the heart. Find if its action is strong and regular. If not, give Digitalis, and you will see a change for the better as soon as the heart feels its tonic influence.
Case I.- A man, aged 50, consulted me for a jaundice of several weeks’ duration. The stools were clay-colored, and the urine saturated with bile. The liver was much enlarged, with soreness and heaviness. The heart’s action was feeble and irregular. No disease of the valves. He stated that the heart trouble preceded the jaundice. Under the use of ten drops of the 1x of Digitalis every two hours he recovered in a week.
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.