In the fourth and the fifth lectures Dr. Bernoville will speak on the drainage of the circulatory system related to the therapeutics of functional troubles and to organic or lesional troubles of the heart. The fourth lecture will be concentrated to cardiac remedies in relation to the subjective troubles or troubles of inflammatory nature. The fact is to be noted that these remedies are almost exclusively used by the Homoeopaths, while in the next lecture he will have to deal side by side with some remedies used in Homoeopathy, some remedies which are common in homoeopathy as well as in Allopathy: the tonicardiacs. In a general way cardio-vascular troubles, the functional, the subjective troubles and the troubles due to the inflammation are really suited to homoeopathic remedies. The organic troubles of the heart with cardiac weakness more or less acute, call on the country for medicines having somewhat physiological action and are related to the law of equilibrium. It is necessary to know in fact how to use the remedies according to the law of equilibrium as well as according to the law of contraries or according to the law of similars.
The functional remedies of the heart that Dr. Bernoville is going to study in this lecture will be considered by him in regard to their application in the practice of drainage. Let us not forget that the drainage is to be effected on all the spheres and one should not use these remedies only to cause to disappear the symptoms, but one should always take account of the remedies of temperament. These functional remedies of the heart will, therefore, be the intermediaries between the remedies of drainage of the outlets and the tonicardiacs on the one hand and the ground remedies or the remedies of temperaments on the other hand. Thus in the case of asystole for example one will use Phosphorus 200 (ground remedy) followed by Aconite 30 and Cactus 30 (functional remedies) with Adonis vernalis (remedy of drainage).
Four functional remedies are of the first importance: Aconite, Spigelia, Cactus and Kalmia latifolia. They are faithful remedies always acting when they are well indicated. They are related to each other by a common symptom: Pericardial pain irradiating to the left arm following the cubital nerve up to the hand but each of them has other special symptoms.
Aconite. Anxiety and Fear of Death dominates. Paleness, sensation of fullness, swelling and bounding of the heart in the chest. Aconite is a very important remedy of arterial hypertension where it is called the lancet of Homoeopaths. It is an important remedy of angina of the heart. (It lowers down the arterial tension which has brutally risen and it checks subjective and objective symptoms that may cause such a high blood pressure). Overworked heart of the athletes. Acute endocarditis with fever. But according to the case the does will be variable and this is very important. In fever use very low potency even M.T., in any case do not go beyond the 6th. In cases of cardiac neurosis and anginas one should use 200 or M. In anginas Dr. Bernoville uses 6 and 200 mixed or 200 alone and repeats at very short intervals. He associates with it Cimicifuga 200 or 6 and 200 mixed which he alternates or mixes with Aconite. In angina these two remedies are fundamentals for him by the side of Glonoin which is to be used in certain cases.
Aconite ferox, a variety of Aconite is more active than Aconite napellus. This Indian Aconite is more violent. It acts better in cardiac dyspnoea than Aconite napellus.
Spigelia. Besides the important symptom of Spigelia, painful symptom of Spigelia, painful irradiation to the left arm, it has violent palpitations aggravated when lying down on the left side with the head bent, amelioration when lying down in a reclining position with the head high. The pulse is rarely irregular. The patient has not the sensation of an anxiety like that of Aconite, but a sensation of malaise with the impression of the beating of wings of a bird (fluttering). He often complains of a retro- sternal pain (irradiated to the left arm). Spigelia has a left laterality very marked. We know that it does not only act on the heart, but also on the trigeminal nerve and on the left eye. From the cardiac point of view it is rather remedy of erethism or acute endocarditis. Erethism is often so marked that the palpitations of the heart may be seen through the clothings. Use 6, 12, 30.
Cactus grandiflorus. It is characterised by an important subjective symptom. The Sensation as if the heart is being squeezed by a vice. The whole heart or the sternum is caught by a vice. This constrictive sensation is felt in the whole organism (head, neck etc.,…). Like Aconite, Cactus is a remedy of hemorrhage of red blood. It acts on the arteries which snap and thus is related to Aconite and Secale cornutum. It is a satellite of Lachesis the ground remedy. Cactus is less faithful than the four other remedies that we have studied. It should be applied in sufficiently lower dilution even in decimals for having good results. Its clinical indications are variable, angina of the heart, hypertension, but without lesion of the aorta, very rarely peri or myo-endocarditis. It is to be compared with a remedy used by the Americans, Hexatoxilon campelianum which has experimentally a sensation of constriction as if from a transversal bar across the sternum. The patient often feels a bar across the heart. The patient often complains of this sensation. When cactus is well indicated but does not act favourably one should think of Cuprum, Cimicifuga or Lachesis in high dilution.
Kalmia latifolia. The subjective symptom is, pain as if from electric shocks which may be felt in the heart or in any other part of the body. The pains are sometimes accompanied by formication (Kalmia is a remedy of fulgurating pains of tabes). These pains often irradiate to the pericordial region or to the shoulder blade (left) and to the left arm. The patient of Kalmia has, like that of the patient of Spigelia, the sensation of fluttering in the chest with great cardiac Erethism. But the capital symptom is notable bradycardia. Kalmia is a remedy of permanent slow pulse. (In Aconite, Spigelia, and Cactus the pulse is regular, rapid or slow). Two points are to be noted. Kalmia is often indicated in persons whose kidneys are attacked and it acts better on a syphilitic ground. It is to be used in 6 and 30.
The trio of medicines in bradycardia is digitalis, Gelsemium and Kalmia.
Digitalis. It is characterised by bradyarrhythmia. Trigeminal pulse. Every third or seventh beat fails in systoles. The patient is afraid that his heart will stop by the least movement.
To this type of pulse caused by auriculo-ventricular dissociation is opposed to that of Gelsemium of nervous patients who have on the contrary the sensation that his heart will stop if he does not move. But Gelsemium is not a remedy of deep action and its action is secondary as regards heart.
Finally, Kalmia has bradycardia of the disease of Adam- Stokes.
The four remedies on which we insist, Aconite, cactus, Spigelia and Kalmia are absolute in the treatment of the heart, either it is the question of cardiac neurosis with palpitation or angina, endocarditis, myocarditis or pancarditis. We have seen that they are related by a common symptom, Pain irradiating to the left arm.
Phytolocca. Its pain irradiate to the right arm. It is, therefore, a remedy which has anginas having paradoxal irradiation. The patient of Phytolocca is often syphilitic whose kidneys are attacked. Fatty heart (Phosphorous, Kali bichromicum)
Then we come to the three important poisons: Latrodectus, Naja, Vipera. We will insist particularly on Naja, a remedy of heart of the first importance.
Latrodectus mactans. A small black American spider which is a classical remedy of angina pectoris in Homoeopathy. Its pathogenesis reproduces point by point the picture of angina. Violent cardiac pain, irradiating towards the left shoulder, or to both the shoulders, or to the left arm or to both the arms with pain up to the little and ring fingers. The pulse is weak, like thread. The patient is afraid of death. He thinks that his heart is going to stop and he will not more breathe. He has pericordial pain. The remedy is generally given in 6. Dr. Bernoville thinks that it is not a faithful remedy and he prefers Aconite.
Vipera. The viper poison has not yet been well studied by homoeopaths. We know that professor Billart of Clermond-Ferrand had done some remarkable works on Vipera. In Homoeopathy it is used in venous circulatory troubles, big varices, hepatomegalis, cirrhosis. From the point of view of the heart its symptoms are still not well known. It must be a remedy of asystole, anasarca of cardiac origin. Its action on liver with the possibility of hematuria is well known.
Here we must speak of Eel Serum and of other venoms such as Crot. and Lachesis. They will be studied later on as ground remedies.
Naja. It is the most important of all venoms in Homoeopathic cardiology. This remedy is irreplaceable and marvellous. It is one of our important remedy of infectious myocardia, or rheumatic endocarditis with a bad general condition and pancarditis. It fails only in streptococcus infection. It is used in different dilutions generally in 6. Sometimes 30 & 200 are required. Dr. Nebel says that for the preparation of antitoxins important doses are injected to horses so that they may fabricate antitoxin; thus experimentally endocarditis with cardiac sound are produced. This is the most important point in Naja. It should be given Systematically and Independently of any Subjective symptoms of the Patient every time when there is the danger of Heart failure in an Infectious condition in a young person. (It will not act on old persons suffering from asystole).