Too long has the constriction phenomenon of the Cactus symptom dominated the scene. As mentioned, Snader repeatedly pointed out the failure stemming form one such indication. If that symptom were really the predominant leading symptom over- shadowing all others, then Cactus would constitute a very extraordinary remedy in angina pectoris. Of course, not every pain in this disease can be called “Constrictive”, but in no other location do patients so designate the sensation of pain as here. Therefore, recommendation of Cactus in stenocardia was not lacking in homoeopathic literature-many quoted authors have spoken in this sense-but the results in therapeutic trials have given very little encouragement.
Also this puts a question of a principal kind, and that is one which concerns the “almost absolute value of the genuine homoeopathic indication.” One hears too often, and especially from followers of the strictly Hahnemannian course (as all homoeopathic physicians should be. S.W.S.). the view that a homoeopathic remedy of proper choice and dosage will unfailingly show its action, so to say, in the sense of a natural law, as long as the human body still has the power to respond to the remedy stimulation.
Never has a statement (though on a weak basis) been asserted- ……for a century-like this, even though the opposite proof is more easily obtained than the positive. Or, how would it be possible that Charette (La matiere pratique, Paris, 1928) carefully gathered typical proof for his materia medica from the total literature, instead of easily quoting from his own practice?.
At times it is difficult to get the leading symptoms, and that is true especially for Cactus. Here two differing reasons must be considered in this uncertainty. First of all: The provings are not the result of a sufficiently large number of healthy individuals, only eight single provings have been (cf. Hughes). These did not at all agrees as to the sensation of pain-constriction. Hence the emphasis on this symptom was perhaps a little hasty, and later, as it has practically almost been customary in remedy proving, been passed on in good faith from one author to another. Thus, finally, was created that unavoidable idea association of Cactus and constrictive pain against which Snader voiced his objection.
But, even if this symptom were incontest correct, there would still be insurmountable difficulties in the simile sense for an experimentum crucis. They lie at times in the different organic substratum of such a symptom. Even though the constriction symptom is referred to the chest, and generally means the heart, yet it is of different importance, whether it is due to a transient vasomotor event in the coronary vessels or to organic changes, be they of arteriosclerotic or luetic origin, or even thrombotic or embolic.
Here belong also the often coinciding equal disturbances of the gastro cardiac symptom complex, heart sensations due to valvular defects, and especially functional anomalies (tachycardia, arrhythmia, etc.). From these differences we naturally find also different reactions to remedies, hence frequent failure from Cactus.
However, it must be remembered also that the disappearance of such a symptom cannot be credited as a sure therapeutic success. Very instructive in this respect is an American work (W. Evans and Cl. Hoyle, The Comparative Value of Drugs Used in the Continuous Treatment of Angina Pectoris) which treats of the question of possible therapeutic action in angina pectoris. Ninety patients with occupation angina were observed for 22 years and treated with the known angina pectoris remedies and frequent interposition of placebos.
There followed 27% of splendid relief, 10.5% were less influenced, while 33% were reported unchanged and 29% had aggravation. This proves how careful we must be in the evaluation of prescribed remedies especially in angina pectoris, …..and that disappearance of the “Constriction” symptom can only be credited to the medicament if it shows up with great regularity in the majority of cases. Since such regularity is not experienced from Cactus, single success with it can not be evaluated very highly. Therefore, it may be time to get away from the “force association” sensation of constriction attributed to Cactus, or at least not to consider it infallible, until a proving of sufficient thoroughness has been undertaken.
Summing up everything it may be repeated that Cactus has no ergotropic action which would make it a rival to the Digitalis group. Its reputation of histotropic action on inflammatory cardiac conditions must still be considered unproved, but should be reproved. Its vasomotor action appears to be its most prominent feature, and so promises most quickly gained results. but it must be remembered that the congestive syndrome gives a more sure indication than the constrictive, which latter has been improperly accentuated. All in all, Cactus is a heart remedy of restricted sphere of action and must not be over rated. ROSTOCK, GERMANY.
