The gastric disturbances are associated with a peculiar sensation as if the stomach we hanging or swimming in water. Then there is a sudden,m sharp aching pain that starts in the back. There is also sharp pain across the chest and in the region of the heart. The pulse is weak and small. the pains are relieved by motion and are aggravated at night and in cool air.

Last year I prepared a paper on acute rheumatic fever and its Homoeopathic treatment. I said then that it would be desirable to have a sequel to that paper in the homoeopathic treatment of metastases of rheumatic fever in relation to the heart.

The frequency of this complication, as shown by the records of five large hospital was, under the salicylate treatment, has a percentage varying from thirty-three to fifty-eight. The frequency was noted in a large hospital where strict homoeopathy was utilized ,and the records showed 15.3 percent.

In a diseased condition showing such tremendous impairment of a vital organ like the heart, as does the metastasis of rheumatism,. we need to give most careful observation and care. Especially do we feel that homoeopathy lends itself as the only hope we have of avoiding the complications, and eradicating their damaging effects. Even though some impairment may be left, Homoeopathy will help these patients back into the way of becoming useful citizens.

Let us consider some for the remedies that will aid us very remarkably in the treatment of these serious conditions.

In Abrotanum we have a valuable remedy. the metastasis following in the wake of a rheumatic condition is very apt to follow checked diarrhoea;and following the acute rheumatic condition,just before the metastasis shows itself, there is marked emaciation of the lower limbs.

The gastric disturbances are associated with a peculiar sensation as if the stomach we hanging or swimming in water. Then there is a sudden,m sharp aching pain that starts in the back. There is also sharp pain across the chest and in the region of the heart. The pulse is weak and small. the pains are relieved by motion and are aggravated at night and in cool air.

In Anacardium we have a remedy having marked action on the connective tissue of the different parts of the body; therefore we look for its usefulness in cases of damaged heart from rheumatic origin. Being a member of the great Rhus family, it is full of rheumatic disturbances. In general, in cases calling for this remedy, we look for pain with the characteristic sensation of a plug,and this time the symptom shows itself in the praecordial region. In general, too, we find relief after eating; and in thee damaged heart conditions we find it equally true, that all conditions are very much relieved for two hours after eating.

The patient is markedly worse from walking, so that he wants to sit or lie down all the time. There is faintness on attempting to go up stairs. there are stitches in praecordial region when breathing, in the effort of breathing or when attempting to walk. These stitching pains extend from the praecordial region to the small of the back. this is a peculiar double stitch in the cardiac region-one stitch is quicklY followed by another,and then a long interval.

We find this remedy having a predilection toward pericardial involvement following the exanthematous disease, is Apis mellifica.

It has attacks of marked dyspnoea; breathing heavy and difficult, even to gasping;markedly worse by lying on the left side. There is a [peculiar sensation about the heart as if something would break away; a sudden acute pain just below the heart extending diagonally toward the right chest. the heart action is very violent; every heart beat shakes the body. There is sensitiveness to slight pressure about the chest.

There is a blowing sound at the diastole. This is one of the remedies shaving a marked mitral insufficiency. the systolic sounds are not well defined, but there is an increase in the diastolic pulmonary sounds.

With all these conditions locally there is the marked bruised soreness as if beaten through out the whole body; the tendency to oedema of appendant parts; scarcity of urine; intense burning and sharp, piercing pains here and there throughout the body,that we always find as the marked characteristics of Apis.

The well-known action of Apis on serous membranes makes it particularly well suited in these cases of pericardium and endocardium involvement, as well as its inflammatory action on connective tissue.

In Fagopyrum we have a remedy of value,little thought of by the majority of prescribers,, having a predilection for inflammatory rheumatism that leaves in its trail a damaged heart. This remedy is particularly applicable in conditions arising in pericarditis.

This is pain about the heart,relieved from lying on the back. The pain extends to the left shoulder and arm;or again it man extend throughout the whole chest. the pain may be bruised,heavy, dull aching, or sharp and aggravated in inspiration. sharp sticking pains in the left side, that come suddenly and to suddenly-a kind of :kink” in the side, not affected by respiration. The pains are aggravated by stooping,as in writing, and by sitting.

There is much throbbing of the arteries. These pulsations may bed seen in the neck,the face and the lips., and may even be heard through the room.This is particularly so after retiring, when the patient will break out in to a sour perspirations.

Fagopyrum has much oppression and palpitation. the pulse is irregular and intermittent. The oppression is made worse by pressure,even the pressure of the hand over the chest; yet the pain around the heart may be ameliorated by the support of the hand over the region of the heart.

These patients are usually worse from 3-6 p.m. and after retiring. They are worse from warmth and from motion,but there i relief from gentle motion.

In rheumatism that has superficial pains in the spring and summer, and very deep metastasis coming on in the winter or from exposure, where the heart has been damaged by repeated attack,we find Colchicum of great benefit. we find the damaged condition affecting the pericardium, but having sympathetic extension t the endocardium.

The mental states of Colchicum manifest themselves in the expression of in tolerable suffering;and external impressions of light expression of intolerable suffering;and external impressions of light and noise,and especially the odor of food,are exceedingly distasteful and distressing to these patients.

There is dyspnoea,with irregular respiration,which is short and rapid. The pulse slows up irregularly,to come on again more rapidly,with a sensation about the heart as if it were being squeezed by a hand,like Casts. there is much infusion into the pericardium, with an irritation of the endocardial membrane. there is a sense of pressure and anxiety in the praecordial region;fullness and oppression,as if the blood stagnated at night, when lying on the left side, compelling him to lie on the right.

The pains of Colchicum go from left to right. Colchicum has a special affinity for fibrous tissue, especially tendinous aponeuroses, which makes it especially applicable in chronic cases of valvular troubles.

In metastases of rheumatism where the heart is involved,and where Arsenicum is indicated,there is burning pain in the region of the heart,a great deal of dyspnoea and oppression,especially on lying down at night and about one oclock a.m. with this dyspnoea the face us desperately pale and white, and there is a look of anxiety and oppression. The patient is covered with a cold, sticky sweat. The pulse is out of all proportion with the rapidity and feebleness. With the intense, tumultuous palpitation in these paroxysms syncope is often noted.

The most pronounced symptoms of the Arsenicum patient are the great restlessness the burning pains, and the very marked prostration, all out of proportion to the apparent difficulty; the oppression from exertion,together with the palpitation and feebleness of the pulse.

Aurum,due to its destructive action on connective tissue, is one of the remedies that may be thought of in the rheumatic endocarditis.

these is a peculiar mental nervousness always present with these conditions,an appearance as if the patient were in a hurry about everything. They do things in haste; they work in haste; even their motions are hurried. There is uneasiness and hurried desire for bodily and mental activity. He cannot do anything rapidly enough to satisfy himself. He is constantly impelled to be in motion, and mourns that he cannot more quickly enough.

With these complications we almost always finds a very slow pulse and frequently a nausea accompanying, as concomitants.

There is difficult and oppressed bathing,and a peculiar quick breath comes involuntarily,almost a stutter in the act of respiration. there are periods of great anguish about the heart,with dyspnoea and feeling of excitement. the heart action is greatly affected by exertion.

Early in the metastasis we find the sudden shooting stabbing pains, extending to the left scapula; an expression of anxiousness to the countenance;sometimes a very weak rapid pulse. with difficult breathing.

In the chronic conditions there is great hypertrophy and valvular insufficiency attending these states. The patient must be propped up in bed; thee is a livid hue to the countenance. The action for the heart is tumultuous and can be seen as well as felt. Usually these conditions are due to involvement of the endocardium with shortening of the chordae tendinae, producing stenosis of the mitral valves.

H.A. Roberts
Dr. H.A.Roberts (1868-1950) attended New York Homoeopathic Medical College and set up practrice in Brattleboro of Vermont (U.S.). He eventually moved to Connecticut where he practiced almost 50 years. Elected president of the Connecticut Homoeopathic Medical Society and subsequently President of The International Hahnemannian Association. His writings include Sensation As If and The Principles and Art of Cure by Homoeopathy.