In this condition you seldom need any active heart medicines. In fact you may be wasting valuable time in resorting to them.
A diet is very necessary as well as very helpful. Carbohydrates must be cut decidedly. Sugar can well be exchanged for comb honey, brown rice for potatoes and bread allowed only at the evening meal. Breakfast is a token meal, consisting of rye crisp, butter and honey, and good ripe apples eaten with the skins on. No tea or coffee, but hot water in abundance. The noon meal should be the heavy meal of the day. A large salad of leafy vegetables, also carrots, spinach, chives, cucumbers, and celery with a dressing of olive oil and lemon juice or just plain French dressing. Roast or broiled lean beef or lamb or fish, if not fat. Nearly all of the raw fruits can be allowed provided they are eaten without sugar.
The coronary conditions (occlusions, thrombosis) are largely due to business strains, overwork, and constant indiscretions in diet and very often come before the patient has any warning or has not heeded it. In the attack such heroic measures as are necessary must be used promptly. I have found the hypodermic very much needed here, but if your patient survives the attack Your patient has a long road, but he travels in bed and on a very limited diet, perhaps only fruit juices or a salad, gradually enlarging the diet as improvement takes place.
He must be in bed for weeks, free from business cares and agitation. Indicated medicines of course depend on the state of his blood pressure and his heart, but appropriate study must be made of the kidney function, the liver, and the entire digestive tract. The remedies mentioned in functional types may still be indicated, but in addition several others with good eliminative powers are useful.
With high blood pressure, liver involvement, headache, dry tongue, and often intestinal gas and umbilical colic, Chionanthus is ten drop doses, three times daily, will do wonders. But the dosage should be reduced as soon as the blood pressure drops to normal. Carduus marianus in tincture is another remedy which may be called for if the tongue is coated, the liver sluggish, and there is a history of alcoholic use and dietetic indiscretions. This medicine is very helpful if sugar is found in the urine.
Low blood pressure is quite a different problem in coronary cases and is much more serious. That indicates either an anemic condition with neurasthenic problems or it may mean degeneration of the heart muscles with dropsical manifestation.
Here we have one remedy which will do much, Crataegus is a bulwark in degeneration of the heart muscles in either low or high blood pressure. It is of little value in endocarditis, either acute or chronic, but cardiac muscles degeneration from arteriosclerosis very frequently calls for it. Many of these cases if not advanced in age can be salvaged, but they must understand that strenuous business must not be entered into. They must also know that heavy eating is dangerous and drinking and smoking must be given up. In addition they must visit their doctor at least once in two weeks for a check up.
You will notice I have not mentioned many of the so called heart remedies. Digitalis, which is used in most heart cases in massive doses, may produce very sudden death from cardiac syncope, unless clearly indicated by its symptoms, such as a slow and irregular heart from old mitral diseases or rapid and weak heart with muscular dilation with cyanosis on movement. The heart feels as though it would stop if he moves. In these kinds of cases Digitalis may be used, but much better results will be attained with high potencies.
I have tried to convey to you in this paper the importance of studying the general system in the heart diseases you meet with. Many of them will prove to be not heart disease primarily at all.
