**Digitalis is known chiefly for its action on the heart, and it is rare that a patient suffering from an affection of that organ does not get **Digitalis in some form. There is no doubt but that it is a much abused drug and when used in strong doses its action is cumulative and dangerous. Its symptoms are, however, clear, and briefly stated, as follows:
The pulse is slow, but primarily strong, there is great weakness of the cardiac tissue, and, secondarily, the pulse becomes weak. Extra exertion increases its rapidity, but diminishes its force, so that the quick pulse becomes irregular and intermittent. This irregular intermittency is a marked symptom.
The heart feels as if the blood stood still. There is weakness and numbness of the left arm, and often blueness of the surface of the body, or cyanosis. The patient fears that the heart will stop beating if he should make any motion. This uneasy feeling about the chest rarely amounts to real pain.
**Gelsemium has the opposite symptom to this. The patient is roused out of sleep feeling that the heart will stop beating, and he is impelled to move about to keep it going.
A number of drugs have numbness of the left arm in heart affections, notably **Aconite, Kalmia, Rhus and Pulsatilla. These are not “keynote ” symptoms, however, as is shown further on.
The Digitalis patient has a doughy look to the skin; there is often a sick feeling at the stomach after eating.
**Apis has a symptom that will lead to its use in heart affections, namely: “He does not see how he can get another breath.” In pericarditis with effusion it is one of our best remedies vying here with **Cantharis, but the latter has burning and spasms. Cartier recommends the 30th or 200th.
Like **Arsenicum and Lachesis, the tendency of **Digitalis is downwards, and it must be used cautiously and only when indicated homoeopathically. There are numerous other symptoms that will indicate Digitalis. Disturbed sleep, apprehensiveness, deep sighing, slow respiration,, dry cough, suffocative spells; in fact, such symptoms as may be caused by an irregular distribution of the blood. **Digitalis is also indicated in dropsical conditions dependent on heart trouble, swelling of feet and ankles, anasarca, cardiac dropsy associated with slow pulse, urine suppressed or scanty. **Apocynum is similar in this relation. The special field of usefulness of **Digitalis is inflammation of the heart muscle approaching insidiously and in sudden cases of myo-or endo- carditis with the symptoms above outlined. The first noticeable benefit is a steadier heart’s action and an increased flow of urine. To use it in strong doses for a long time will render the patient incurable.
Cactus grandiflorus. [Cact]
Perhaps the next most important remedy in heart affections, from the homoeopathist’s standpoint, is Cactus. Its well known characteristic symptom, “Sensation as if the heart were grasped with an iron hand,” which clutches and relaxes alternately, is ever present to the mind. It should be borne in mind that not all patients express themselves alike. A squeezed sensation may mean the same symptom. It has, however, other symptoms. It is similar to **Arnica in chest soreness and constriction; it has pains shooting into the left arm, oedema and a quick, throbbing, tense, hard pulse, which may or may not intermit. Carditis and pericarditis may call for Cactus. It presents a better picture of rheumatic carditis than any other remedy. It seems to lie midway between **Aconite and Digitalis. It controls the inflammatory condition and strengthens the heart’s contractions, and does not poison the heart like **Digitalis or Strophanthus.
There is great irritation of the cardiac nerve and **Cactus may be found to be the remedy for angina pectoris. It is a remedy adapted to hypertrophy of the heart in young people. It is also very useful in intense palpitation and fluttering sensations about the heart; it is indicated for such symptoms in young girls about the age of puberty and at menstrual epochs. Difficult breathing, suffocative, fainting, violent palpitation and inability to lie down are symptoms indicating the cardiac asthma or dyspnoea.
Kalmia latifolia. [Kalm]
**Kalmia is a remedy for cardiac hypertrophy, especially after rheumatism, and has the symptom so common in heart affections, namely, “numbness of the left arm.” There is with **Kalmia much pain and anguish about the heart, some dyspnoea, palpitation, and pressure from the epigastrium towards the heart. The heart is irregular and intermits every third or fourth beat. There are shooting pains through the chest to the scapula.
**Kalmia is an excellent remedy for cardiac troubles when they have been caused by the suppression of rheumatism by external applications. The pulse of Kalmia is slow, but not as slow as Digitalis.
**Phytolacca has tingling and numbness of the right arm, but the three chief remedies having this symptoms in the left arm are **Kalmia, Rhus and Aconite. These pains, as Prof. W.B. Hinsdale points out, should not be considered as “keynotes.” Their symptomatic value consists in pointing to a class of drugs rather than to an individual drug. The minutiae of the pains should be studied.
Acute pericarditis depending upon rheumatism will call for Kalmia; the sharp pains taking away the breath will call attention to it. Hering says Kalmia has a most beneficial action in diminishing too rapid pulsation of the heart.
**Spigelia is another remedy for the painful affections about the heart. It stands at the head of the list for acute carditis and pericarditis. There are sharp pains shooting from the heart to the back, and radiating from the heart down the arm, over the chest, and down the spine. There is palpitation worse from any movement of the arm or body. There is a purring sensation felt over the cardiac region when placing the hand thereon. The pulse is intermittent, not synchronous with the heart beat, and the slightest motion of the arm or hands makes the patient worse. Heart symptoms accompanying neuralgia call for **Spigelia. Irregular and tumultuous action of the heart are well met by **Spigelia. At times the heart beat is even audible. We sometimes find this symptom under **Arsenicum, which is useful in hypertrophy of the heart from climbing high places, mountains, etc., but **Spigelia comes in earlier in heart troubles than does **Arsenicum.
Rheumatic endocarditis will often find its curative remedy in **Spigelia, and it has a most beneficial action in angina pectoris. In cardiac inflammation it comes in after **Aconite. It corresponds well to chronic affections of the heart, particularly valvular disease and hypertrophy.
This is a remedy often indicated in heart troubles, especially when they supervene upon chorea or rheumatism of the bellies of the muscles. The headache confined to the forehead or as if the top of the head would fly off is present and an indicating feature. Pain under the left nipple and down the left arm may also be present. The pains is apt to come in shocks. Insomnia is persistent.
Among the remedies having a marked influence of the heart is **Aconite. It has, as has been seen, numbness of the left arm; it also has tingling in the fingers, associated with heart disease. **Aconite produces a cardiac congestion, with anxiety, oppression and palpitation, worse when walking; lancinating stitches occur, and also attacks of intense pain. It is the remedy in uncomplicated hypertrophy of the heart. In pericarditis and endocarditis when the inflammation sets in with fever with the intense mental anxiety so characteristic of the drug. The 30th acts marvellously in these conditions.
**Glonoine has a fullness in the region of the heart, with some sharp pains, fluttering of the heart with violent beating, as if the chest would burst open. Labored breathing pains radiating in all directions, even into arms. Must have head high and a pulsating headache to well indicate the remedy.
**Amyl nitrite has oppressed breathing and constriction about the heart. Both of these latter remedies are useful in angina pectoris.
**Veratrum viride has a condition simply of intense arterial excitement and is recommended as a remedy to be used continuously in hypertrophy with dilatation. The force and frequency of the pulse are abnormal, as a rule slow, sometimes rapid. It is an important remedy in all inflammatory affections of the heart and its membranes, especially those caused by infections.
Rhus toxicodendron. [Rhus-t]
Rheumatic hypertrophy calls for Rhus. It is a palpitation of the heart from over-exertion, with numbness and lameness of the left arm and shoulder. Pericarditis or endocarditis from exposure to rain, getting wet, etc. These symptoms are worse on every change of the weather. Uncomplicated hypertrophy of the heart such as comes in athletes, machinists, etc., calls for Rhus; and among other remedies for this condition may be mentioned **Arnica and Bromine.
Pericarditis due to septic condition will call for **Rhus, and in heart troubles, as in all others, it follows **Bryonia well; and **Bryonia may be an early remedy in pericarditis. The rheumatic basis of nearly all the heart symptoms and the general condition of the remedy will decide.
In affections about the membranes of the heart, of course, **Bryonia is one of the most prominent remedies. It corresponds to the first or second stage of pericarditis when of rheumatic organ and especially if pleuritic symptoms be present. There are intense fever, frontal or occipital headache, and acute stitching pains which are aggravated by movement, and the friction murmur is always present. It does not usually corresponds to pericarditis from Bright’s disease or pyaemia.
**Asclepias tuberosa is similar to **Bryonia, but the symptoms are not so acute, the fever is not intense, the pain is pricking and extends to the left shoulder; there is a dry spasmodic cough and the pain is relieved by bending forward.
A valuable group of symptoms calling for **Bryonia is the following : Cramp in region of the heart, aggravated by walking, raising one’s self or using the slightest exertion, even raising the arm. Heart beats valiantly and rapidly.
There is quite a large class of remedies affecting the heart which might be termed the newer remedies. Among these in **Convallaria. It is useful in valvular diseases of the heart with scanty urine, dropsy and great dyspnoea. It has so relieved the oedema in a number of cases that the patient could lie down. Dyspnoea, palpitation and oedema due to mitral disease have been relieved by it. The provings of the remedy show a feeble heart sound, anaemic murmurs over the jugular vein, pain in region of heart and an uneasy fluttering; a sensation when exercising as if the heart stopped beating and then started up again, causing a faint, sick feeling. This uneasiness about the heart should suggest its use in the condition known as cigarette or tobacco heart.
**Agaricine should also be thought of in patients addicted to the excessive use of tea, coffee, or tobacco. Twitchings should be present to well indicate the remedy. Dilatation associated with emphysema.
Another of the new remedies is **Adonis vernalis. It increases arterial tension, regulates the heart beats by lessening the frequency of the pulse and increasing the force of the cardiac contraction. Blackwood thinks anasarca should be a prominent symptom with scanty urine, low in urea and asthma or dyspnoea present. Dr. Gisevius, of Germany, believes that a leading indication for **Adonis is a previous attack of rheumatism. It may be useful in serious dilatation or even in fatty degeneration. The remedy is well tolerated, increases diuresis and acts with rapidity. Otherwise it is similar to **Digitalis. Cowperthwaite praises it in feeble heart action, saying that it is far better and safer than **Digitalis, the continued administration of the latter being exceedingly dangerous, to which the writer heartily agrees.
**Lycopus Virginicus is still another heart remedy of this class. It is useful in cardiac irritability with depressed force, after abuse of cardiac depressants or cardiac stimulants, excessive hypertrophy, muscular weakness, etc. Its use has been limited, chiefly confined to the condition known as cardiac asthma, where it works well. The rapid regular pulse, tumultuous and forcible heart action, indicate it in exophthalmic goitre.
Another remedy useful in irritable heart is **Collinsonia, and **like Digitalis and Lycopus it is secondarily homoeopathic. It suits hypertrophy of the heart with palpitation and pain. Irritability of the heart due to suppression of haemorrhoidal flow especially indicates **Collinsonia.
**Strophanthus is one of our recent accessions to the line of cardiac remedies. Dr. George Royal thinks it acts better in the lower dilutions, 1,2 or 3, than in the customary large doses of the tincture, and many observers have verified this observation. It has been found useful in weak, hypertrophied, irritable heart, with tense arteries and a free discharge of urine. It relieves dyspnoea and praecordial distress and promotes diuresis and removes dropsy. It is useful in heart failure of the aged and heart diseases in children. It reduces the pulse and increases the power of the heart. It probably suits better heart troubles dependent on kidney disease, or where coffee, tea, tobacco or alcohol have already poisoned the heart.
**Crataegus oxyacantha. This is a new remedy, and useful when the hearts action is feeble and irregular and the pulse small and intermittent; sensation as if the heart would stop. It suits cases of failing compensation with dilatation of the heart and also fatty hearts. It acts well in functional diseases of the heart, palpitation and tachycardia dependent upon anaemia. In threatened heart failure during acute diseases it will frequently work well. Exhausting overwork. Nervous shock and neuraesthenia are casual symptoms. Dr. G.H. Wells gives a painful sensation of pressure in the left of the chest below the clavicle as a verified indication. As a palliative in heart affections it is a far safer remedy than **Digitalis and can be used for a long period as a tonic to weakened hearts.
**Sparteine sulphate has also been used in feeble heart and nervous and hysterical persons, and at the climacteric; but as most of these remedies are used for the physiological effect they, as yet, should find no place in homoeopathic therapeutics. **Sparteine is said to be further indicated when compensation is failing and the hearts action is weak; the pulse is irregular, feeble, and dropsy is present; there are dyspeptic symptoms with great accumulation of gas in the gastro-intestinal canal and the patient is subject to nervous and hysterical attacks. Sudden painful “seizures” may further indicate **Sparteine. In such cases its use will be palliative.
The snake poisons exercise as a marked effect on the heart and circulation, as well as on the blood itself. **Lachesis produces a palpitation of the heart and a constrictive feeling in the cardiac region. There is a smothering sensation about the heart, waking the patient out of sleep. He can bear no pressure on the chest. Pulse small and weak. It has more septic elements than the other venoms.
**Kali hydroiodicum has this same smothering sensation about the heart, waking him out of sleep and compelling him to get out of bed.
**Graphites has a similar symptom, and also a cold feeling about the heart, found under **Petroleum and Natrum muriaticum as well.
**Naja tripudians, another of the snake poisons, has been used with good effect in valvular affections of the heart with a dry, teasing cough; there is also a tremulous action. The pulse is slow, the patient is melancholic and all the symptoms are worse from stimulants and better walking or riding in the open air. It is a remedy that should not be overlooked. Hypotension is marked. It has much pain and resembles herein **Spigelia, but it comes in later in valvular affections. Reflex palpitations and cardiac pain associated with ovarian neuralgia, well indicate **Naja.
**Oxalic acid is a useful remedy to subdue the praecordial pain which radiates so frequently to the left shoulder in cases of aortic insufficiency.
**Lachesis has also the symptom that the heart feels too large for the chest. Atheromatous conditions of the heart and blood vessels call for **Lachesis, especially in old people when symptoms of dropsy are present.
Lilium tigrinum. [Lil-t]
**Lilium has some important heart symptoms. It has a pain in the heart as if grasped in a vise, which awakens the patient suddenly. There is much fluttering about the heart, and faintness. It is a sensation as if the heart were grasped and then released. **Lilium will be found useful in purely functional affections, independent of organic lesion. There is much cardiac irritability nervous palpitation and the symptoms are ameliorated by lying on the left side. Motion aggravates.
**Sulphur may be the remedy when it seems as if there were almost too much blood sent to the heart, producing palpitation, grasping for breath, and sensation as if the heart were too large for the chest.
**Lilium is useful in conditions of nervous palpitation, and in functional cardiac disorders in women with uterine disease.
**Arsenicum is a remedy often thought of in heart affections and often useful. Like **Lachesis, it is more adapted to later stages of heart trouble, when the course is downwards. **Arsenicum produces great irregularity of the heart, or the pulse may be quick and weak. It is especially useful in pericarditis or endocarditis after suppression of measles or scarlatina. A grand remedy in disease of the heart depending upon constitutional causes like sepsis, also in affections of the heart depending upon fatty degeneration of the blood vessels. Restlessness will be present, and oedema, puffiness of the eyes and swelling of the feet. Great dyspnoea, attacks of suffocations at night on lying down and particularly after midnight.
**Phosphorus affects rather the right heart producing a venous stagnation, and it is exceedingly useful in fatty degeneration of this organ.
**Vanadium 6X, said Dr. A. L. Blackwood, is of service in strengthening the heart’s action when there is present fatty degeneration of the liver and heart, with degeneration of the arterial walls. It will be found of special benefit in those cases where anaemia, chronic rheumatism, diabetes, neurasthenia or tuberculosis is the exciting cause. It increases the appetite and strengthens the digestive function.
**Arsenicum rather affects the left heart, has more oppression of the chest in breathing, more orthopnoea and more anasarca. The patient cannot lie down or go upstairs.
Two other remedies useful in fatty degeneration of the heart are **Cuprum aceticum and Phytolacca decandra.
In functional disorders of the heart, **Collinsonia is an excellent remedy, especially when they are reflex from haemorrhoidal troubles or alternate with them. Although the provings do not indicate a specific action on the heart, it has been found useful where there is much cardiac irritability, traceable to suppressed haemorrhoidal bleeding, the cardiac nerves seem irritated, and there is great sensitiveness about the heart, fullness and oppression about the chest, with difficult breathing and faintness. It cured for the writer a case of severe constrictive pain about the heart in a man who habitually passed blood with his stools; upon the disappearance of the blood from the stools the heart symptoms commenced and when the flow of blood became re-established the heart symptoms disappeared. **Collinsonia entirely cured both conditions. A characterizing indications is a persistent, rapid, but weak pulse; the action is excessive, but the force is deficient. Hale thinks **Collinsonia acts on the heart by removing obstruction or irritations in the liver, portal system, or kidneys, and by increasing muscular tonicity.
This is a pure and simple heart stimulant. Its only legitimate field is when paralysis threatens and during the course of any affection, you have dyspnoea, blueness of the finger tips and lips, sour eructations and symptoms of disturbed digestion. Here 1/64 of a grain hypodermically may bridge the chasm. Its frequent and injudicious use is more than harmful and leads to an increased mortality in many affections.
**Caffeine is another powerful heart energizer, but is not a curative remedy.