We, as physicians, are constantly called upon to decide whether a given patient has real or imagined heart disease. In the majority of cases the decision can be made from an accurate history, from the subjective symptoms, plus what is observed and found with the ordinary means at our disposal. Where this is still insufficient, a cardiologist should use all the diagnostic means at his commands. I believe an older man who has had some years in general practice before specializing is the best one to pass an opinion.
Upon this opinion should rest the future living habits of the patient. Where no organic heart lesion can be found the patient can be relieved by reassurance and given appropriate treatment.
One symptom many patients complain of is rapid pulse-many of these have always had a rapid pulse-some have it only in attacks, or periods, which come suddenly, last for a few seconds or minutes to several hours. When observed in such an attack the patient is frequently flushed. It is probable the mechanism is very similar to that of women in the menopause, and indeed it may be a symptom of change in the male.
The dominant school use quinidine daily to alleviate this and may give it for years. We, of course, use the indicated remedy which may be Lachesis, Strychnia phos., Sulphur, Gels., or Valerian.
In cases where the pulse is rapid all the time and there are no signs pointing to hyperthyroidism, I believe Craetageus, given over a long period, is the best remedy.
Many case of rapid pulse, flushing, and pulsating throughout the body are actually due in large part to a hyperthyroid state. I believe also that a thyroid may be very active for short periods then back to normal for periods- a sort of intermittent hyperactivity. This is seen in very nervous people who blush at their neckline in front. These patients often need Nat. mur., Ferr. met., Phosphorus, Calc. Phos., or Sulphur.
Then we have the ones who are short of breath, bluish lips, sighing, slight puffiness of the ankles, yet on examination the blood pressure, urine, and heart sounds are within normal limits. These patients are frequently a little too stout; they need graduated exercise out of doors such as walking, less to eat and more rest. Remedies for this class are Lachesis, Asafoetida, Digitalis, Ignatia, Calcarea carb. and Sulphur.
Pain in the region of the heart and left chest, front and back, is common and may be due to arthritis of the spinal articulations in the cervical or upper dorsal region, or due to the so-called intercostal neuritis, or may be of rheumatic origin. It may be the cause reflexly of rapid heart action. These pains may extend to the left shoulder and side of neck or to the back. They come frequently when at rest, or when sitting, and are helped most by Spigelia, Ranunculus bulb, Kalmia and Sulphur.
Then we have the people who complain of weakness, weak spells, gone feeling about the heart, or every shock is felt in the region of the heart. Examination may disclose some irregularity in heart action-a sudden jump or jerk-possibly an old murmur which has been there for years following rheumatic fever, diphtheria or scarlet fever. These are more functional than organic and a little medicine and warning about more rest and less exertion is sufficient. Remedies for this class are Digitalis in potency, Pulsatilla, Ignatia, Lachesis, Kalmia.
Next we have the ones with heart pains who say, “It is due to my gas;” they belch and the pain goes. The pain is as if from pressure of wind and is relieved by belching or the passage of flatus. However, this pain comes after eating and then hurrying as for a bus, or when going up a slight incline, i.e., from exertion. These patients are experiencing mild angina and should be so warned. Remedies: chief is Carbo veg., next Lachesis, then Cactus grand, Argentum nit., Valerian, Latrodectus mac., and Sulphur.
Here follows a short case history of heart block treated homoeopathically: Feb. 1, 1949. This man, of between 65 and 70 years, very active, wiry and a great smoker, suddenly felt weak and short of breath. His pulse rate became slow-30 to 40 beats per minute. Electrocardiogram showed heart block. The specialist advised no effort be made to re-establish the normal rate. B.P. 90/60; breath became shorter, smothering attacks on going to sleep. Grindelia, Sambucus, Lachesis and Carbo veg. were given as indicated. By April 26, he was up and about, and from then until Nov. 5th 1950, was O.K., drove his car, moved stones at the cottage, painted, and ate well.