PAPERS ON SUBJECTS RELATING TO DISORDERS OF THE HEART



And it is also the duty of the constituted authorities, the members of the Board of Health, to refuse to receive reports ascribing sudden death to heart disease, or any other alleged cause, unless they are fully satisfied that the physician has investigated the condition of the patient, before or after death, in a competent and scientific manner. The neglect of such an evident duty, has often resulted in the covering up of gross ignorance or a terrible crime.

COLLINSONIA IN IRRITATION OF THE CARDIAC NERVES.

THOSE physicians who are familiar with the history of the introduction of the Collinsonia as a remedy in the homoeopathic school, are aware that it was first mentioned in the first edition of New Remedies. In the second edition an additional proving, by Dr. Burt, was published, which proving verified many of the symptoms previously given. Mention was also made of a discussion before the Western Institute of Homoeopathy, relative to its use in cardiac affections. Several physicians testified to its value in disordered action of the heart.

On page 258 of New Remedies will be found a report of the curative value of Collinsonia in a case of pulmonary hemorrhage. It is to be regretted that the condition of the heart and circulation was not mentioned, as it might have thrown some light on its action in such cases. Is it not probable that it assisted the hemorrhage by virtue of its homoeopathicity to irritation of the heart with too great action?

Since the publication of New Remedies, in 1867, much additional experience with Collinsonia in cardiac affections has been published, principally by the Eclectic school, and some valuable clinical observations by our own.

The most valuable contribution to the clinical history of Collinsonia has been from the pen of Dr. M. M. Fenner, of New York, and published in the Proceedings of the New York State Society (Eclectic). He states that he has found it most useful in that condition known as “irritation of the cardiac nerves.”

“Every practitioner,” he says, “is familiar with cases of excited actions of the heart, that he could not refer to any palpable cause. It is common in one’s daily practice to meet with perturbations in the rhythm of this great centre of the circulation, but it is usually not different to find the offending cause.”

The causes of this affection are derangements of the digestive organs; abuse of stimulating liquors and condiments; derangements of the portal circulation; excesses in venery; mental emotions; or any causes which impair the integrity of nerve tissue.

THE SYMPTOMS.- Idiopathic cases of this affection may occur, in which the abnormally and persistently increased action of the heart may be all that may be discovered.

But it is generally a sympathetic affection, arising from reflex irritation, transmitted from disorder of the stomach, lungs, uterus, and other organs.

The more common symptoms are pressure in the praecordia, a feeling of fulness in the chest or heart, or both. Dr. Fenner says it is always so far as he has observed it periodical, perhaps intermittingly so at first. The pulse beats rapidly, full, and strong, sometimes reaching as high as 140 beats in a minute, but more often about 120. Generally, more or less of oppression and pain exist in the chest, sometimes with a feeling of faintness.

Any unusual stir, or the appearance of strange faces, will usually increase the rapidity of the pulse, and aggravate all attendant symptoms in a marked manner. So much is this the case that the patient will live in constant dread of hearing or seeing something new. This condition is quite common in woman suffering from spinal irritation or uterine disorder.

After a full meal, the taking of stimulating drinks, or any other circumstance calculated to excite vital action, all the symptoms will become temporarily aggravated. During sleep, on the contrary, the patient becomes comparatively quiet, with respect of cardiac pulsations, until the latter stages of the disease, when even in this state of repose he shows the abnormal cardiac action. The irregularly periodic action becomes a sustained effort.

Thus the disease continues until the sufferer is worn out by the continued exalted action. He becomes emaciated and effeminate; distressingly sensitive to all external impressions. There seems to be no tendency to spontaneous subsidence of the symptoms, and recovery. The disease once established, from whatever cause, seems to be self-sustaining, and continues, although the cause may disappear, until relief is obtained by treatment, or death claims his victim from this alone, or the conjoined effects of this and some supervening disease.

This affection has yet hardly a place in the established nomenclature of diseases. Watson mentions it under the head of “irregular action of the heart.” He says: “Besides these over- strong or irregular movements, which are symptoms of disorder of the stomach, there are palpitations of a purely nervous kind; I mean they depend upon a peculiar and highly sensitive condition of the nervous system.”

In Scudder’s Practice (Eclectic) there is a section devoted to “Excited Action of the Heart,” and referred to as a symptom of. 1st. Derangement of the circulation; 2d. Derangements of contiguous viscera; and 3d. Irritation of the cardiac nerves. Dr. Handfield Jones, in his excellent work on “Nervous Disorders,” gives, under the head of “Cardiac Neurosis,” a full description of this affection, illustrated by numerous cases. He would call the disorder “Cardiac hyperaesthesia.” He says: “A common form of cardiac neurosis is that when the action of the heart is much accelerated, varying from 110 to 140 in the minute in the standing position, and not falling much below the former figure in the sitting. The contractions are abnormally sharp and vivid; the organ seems to spring up with a quick, forcible leap against the ribs. The apparent excess of action misleads the practitioner sometimes to suppose that there is hypertrophy. Percussion, however, shows that no enlargement exists, and auscultation detects no vascular bruits, nor derangement of the rhythm. The feeble stroke of the radial pulse often contrasts markedly with the vivid action of the heart. The general condition of the patient exhibits, more or less, indications of debility.” Dr. Jones considers the excessive use of tea to be the principal cause of this condition.

My own experience in this affection has satisfied me that it often has its origin in spinal irritation, either reflex or idiopathic. It may have a rheumatic origin, in which case it might be called a “rheumatic neurosis.”

According to Bezold, the nervous centre of the cardiac movements furnishing three fourths of the entire propulsive force of the heart, occupies the cervical region of the cord, including the medulla oblongata, and extends as low as the fourth dorsal vertebra. Its fibres run through the cervical spinal cord, and pass out between the seventh cervical and fifth dorsal vertebra, probably passing through the lower cervical and upper dorsal sympathetic ganglia and proceeding to the heart. If we suppose a rheumatic disorder, assuming the form of intercostal neuralgia, it is not difficult to understand how, by extending backwards and involving the origins of the upper dorsal nerves, it might induce a rheumatic neurosis of the cardiac nerves, resulting in hyperaesthesia.

I have often found in cases of excited action of the heart a tenderness of one or more of the cervical or dorsal vertebrae, or a tender spot on one side or the other of the spine.

TREATMENT.

Before proceeding to the examination of the value of Collinsonia in this affection, we will make some inquiry into the treatment usually adopted.

Handfield Jones, who may be considered the best allopathic authority, says: “The treatment of cardiac hyperaesthesia is too often unsatisfactory, probably because it is impossible to obtain rest for the organ. An irritable brain or stomach may be soothed by giving them timely repose, but we can do this but very partially with the heart. Belladonna plasters are generally useful. Internally, I have seen most benefit from tinctura digitalis, fifteen minims a day, but I am not altogether satisfied how far it is quite safe to give this drug in states of cardiac excitement. In conditions of cardiac languor I have no fear of it, but in the opposite I think we must be cautious.”

[Digitalis is doubtless homoeopathic to cardiac hyperaesthesia, but only when it depends on a secondary condition characterized by loss of tonicity. In this condition it may be given in the lower dilutions with success.]

Dr. Jones also suggests Opium, Nitrate of Silver, Aconite, and Hydrocyanic acid. In another place he says all nerve tonics tend to decrease and strengthen the action of an excited and weak heart. This is doubtless the case owing to the fact that primarily all tonics increase and excite the action of the heart to an abnormal degree, while secondarily they cause an irritable and weak condition of that organ.

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.