In taking the history of this patient, I learned that he had been on good size doses of Digitalis for several months. This was commenced when he was visiting Palm Beach. On his return to New York another physician was consulted. He claimed that sings of Digitalis poisoning was present and reduced the dose, giving three grains daily. I insisted that he take no Digitalis, and that he should never have taken any. That I was right, was proved by the fact that he grew worse under its use.
The bronchitis responded nicely to Phosphorus 30x. Later he received Gelsemium because of the languid, stupid, weak condition which existed. When the bronchitis was cured, I prescribed Crataegus tincture, five drops four times daily. he is now up and about his business. The condition of his heart has improved to a remarkable degree.
I have seen other cases of senile heart do very badly under Digitalis, and I think that many a life has been shortened by its routine use. Sclerosis of the coronary artery usually exists. Under Digitalis its lumen becomes more narrow and the heart receives less nourishment.
Fortunately the homoeopathic school has other cardiac remedies that are indicated for cases to which Digitalis does not apply: Spigelia with its rapid, weak, tumultuous action: Kalmia with its slow, weak pulse; Cactus grand. with the characteristic constrictive pain; and many others play an important part in our practices. I have found Iberis very useful in cases of tachycardia. Crataegus is a favorite. Aconite nap., Aconite ferox, Apocynum, Adonis, Arsenicum alb., Arsenicum iod., Aurum met., Arnica, Convallaria, Grindelia, Kali iod., Lachesis, Laurocerasus, Natrum mur., Naja, Phosphorus, Strophanthus, Squilla, Sumbul, Tabacum, Veratrum alb., Veratrum vir., etc., are among other remedies which have served me when their characteristic symptoms were present.
Before closing I would like to mention a remedy that has produced marked results in some of my cases of angina pectoris. One patient, a man weighing about 240 pounds, suffered so acutely that he could not even move his hand without great pain in the cardiac region. So rapid and marked were the results of this remedy, that he returned to his work which necessitated, long, hard auto trips. Another case was that of a butcher. His business required considerable physical labor and marked changes to extremes of temperature.
The promptness and completeness of his cure (I say cure because he has had no symptoms for over a year) was remarkable. I think that I am keeping one old gentleman about his business, who thought that he was about to take his last journey several years ago, with the aid of this medicinal substance. I refer to Latrodectus mactans. I gave the seventh centesimal potency.
One word more. Do not forget that rest is a wonderful remedy for heart failure, and that a moderate amount of alcohol (wine, a high ball on retiring, or the equivalent) often proves of great benefit to angina pectoris patients.
NEW YORK, N. Y.
DISCUSSION.
DR. W.B. GRIGGS: I dont think there is another drug that is more daily proven than digitalis. There isnt a pharmacological laboratory that manufactures digitalis preparations that isnt pharmacologically testing each batch of digitalis put out, and any man who knows anything about pharmacological work knows that it never changes. Digitalis one hundred years from today will do what it is doing today.
If you are going to use digitalis, use it where you have all of the alkaloids used. Use it in the powder, in small doses, a grain or two. In my 36 years of hospital work I have seen small doses persistently given to the patient produce better results than these tremendously big doses. That is also borne out in the experience of my co-laborers.
J.W. WAFFENSMITH: How much do you give?.
DR. GRIGGS: One ounce twice to day.
DR. A.H. GRIMMER: Digitalis is too often abused, but it undoubtedly has a specific place, a very important place, in those cases of heart disease that are on the borderline of incurability.
DR. C.B. STEARNS: I think we ought to appreciate this paper because, if you remember, it tells us what to do in the worst cases we get, the kind that we sweat blood over, the that sometimes get by us if we dont do something of this sort, and the doctor has limited its use to the very types in which it will do what you can call good. I have seen such cases, I have lost them, and I think we all have. They get water-logged, and unless you give something of that sort you lose them. But after you get them straightened out, after you have palliated until they are on earth again you can sit down and work your case out sometimes and bring them around so that you dont need to do it again. In some of these I believe you have to do it once in awhile. This is a valuable paper in showing you where and when and how.
DR. C.L. OLDS: Nash in his Leaders speaks of the use of a trituration of the leaves used in the 1x in cardiac dropsy. I think the way he uses it, he takes one grain of the 1x, places it in a teacupful of hot water and allows it to stand there an hour and repeats that about every two or three hours until he gets his effects. I have tried that with some success.
DR. J.W. WAFFENSMITH: In the typical digitalis case where the patient has been digitalized and has had the remedy over a long period of time, I want to throw out the thought that very often Digitalis in the potency will start the process that you are looking for in a favorable direction. I had a case this spring that ran very true to this and after I gave a single dose of the remedy in potency, another remedy, which was the constitutional remedy, came to the surface and the case got well.
DR. A. PULFORD: There are direct indications for digitalis. We havent heard them.
DR. D.E.S. COLEMAN: You mustnt give doses large enough to produce a heart-block.
DR. Stearns is perfectly right when he says that after we help these cases with digitalis we can often sit down and pick a remedy that will give them great relief, sometimes cure, and sometimes relief, not always a curative relief unfortunately. Dr. Nash used the second centesimal potency.
Dr. Dixon said he has an allopathic friend who claims that these cases of auricular fibrillation will die within a year. That is not so. They will live for years and years if you treat them right. You can keep them going year after year.
Dr. Pulford wanted to know the indications for digitalis. I thought he knew them so well that I didnt have to say anything about it. I just touched on it briefly. It is the slow, irregular pulse. That was the leading indication. There area lot more: The auricular fibrillation and all the irregularities. I thought Dr. Pulford know them so well he didnt want to have me mention too many of them. That wasnt the object of the paper because everybody knows the indications for digitalis.
