EVER since the days of the Great War I have been interested in had intrigued by Neurocirculatory Asthenia (“Irritable Heart”- “Effort Syndrome”) because it was among soldiers that I first saw that could be experienced by a person suffering from this form of neurosis. After the War it was quickly realized that many people in civilian life likewise succumb to this functional disturbance. I like to think of it in terms of Stevens definition-namely, “a subconscious defence reaction to an intolerable situation” represented variously by hardships, anxiety, grief and worry. Let us pause and think how frequently and in what a variety of phases this condition can arise and we are forced to marvel that at least every second individual we meet has not fallen a victim to it. That this is not true leads us to wonder at the almost limitless resilience of most human minds and bodies.
The subject is a timely one when the nervous systems of many executives and business men are cracking under the long continuing and constant stress of our times. Eventually this persistent load of tension would surely lead to absolute breakdown in the nervous, cardiac and renal spheres especially, unless some therapeutic agent could be applied that would stimulate the various tissues of our complex human mechanism so that they became able to withstand the constant shock of these cataclysmal forces. such agents are to be found among the various invaluable remedies in the homoeopathic materia medica. Naturally any sane medical or lay observer says, “But first remove the cause.” Very wise and very true we grant, but we claim that, failing to be able to do the latter because of our impotence to control the vast economic factors at work, recourse to the former method is logical, sound and beneficial. This to my mind conforms to the best noblest in homoeopathic philosophy.
I experience considerable temerity in presenting this subject matter before an audience of homoeopathic physicians because I am able to present only known facts in possibly slightly different lights. Oftentimes, of course, one must stand in a position analogous to the evangelist who must urge his flock on toward the heavenly goal by repeated exhortation.
The symptoms are varied but classical-easy fatigue under mental or physical exertion, rapid exhaustion, excessive sighing, sense of suffocation, various types of chest pain, especially precordial, palpitation, abnormal pulsations, tachycardia, bradycardia, syncopal attacks, headache, tremors, dizziness, visual disturbance, insomnia, and symptoms of various gastro- intestinal neuroses. Having make the general surroundings as pleasant as possible, we see to it that these people have wholesome food, sufficient sleep, graduated exercise, and adequate amusement. The physician, with his milk of human kindness, can administer psychotherapy in the form of helpful suggestions, and optimistic assurances. But, strange, to say, it is often the properly applied homoeopathic remedy that acts as the synergistic agent which marshals all these forces to the end that perverted functions are again returned to normal paths.
Aconite I have found very useful where the marked anxiety and fear of death were present together with a rapid, bounding pulse and severe, knife- life pains in the intercostal nerves.
Chininum arsenicosum. General weariness, exhaustion and prostration are marked. There are palpitation and attacks of suffocation. The patient craves the open air.
Cinchona officinalis. Periodic attacks of debility, apathy, despondency, palpitation with sense of rapid irregular cardiac action. This is often associated with marked intestinal distension, profuse sweats, wandering pains in the extremities, sleeplessness or unrefreshing sleep with frightful dreams.
Natrum muriaticum. Fluttering sensation in the precordium and the feeling that the heart pulsations shake the whole body. Cannot stand consolation. Goes into a rage about trifles.
Nux vomica. Frequently applicable to the quick, active, nervous business man with his preponderance of mental work and sedentary life. He reacts poorly to stimulants, sleep poorly, has much gastro-intestinal disturbance followed by vertigo, palpitation and tachycardia.
Digitalis. Years ago Dr. Raisbeck did me an invaluable service when he pointed out that this remedy in freshly prepared homoeopathic dilutions business man who had become anxious and despondent about the future, showing weakness, vertigo, mental confusion, violent palpitation, often a weak, slow pulse, frequent stitching pains through precordium, and continued insomnia.
Ignatia amara. Alert, nervous, apprehensive, tense, sensitive, cries easily, constant sighing, introspective, melancholy and brooding; symptoms aggravated by tobacco and coffee; sense of goneness in the heart and stomach, feeling of lump in the throat. Pulsatilla, chamomilla, and passiflora need to be carefully studied and differentiated from ignatia.
Latrodectus mactans may be very useful if attacks of precordial pain with the agonizing intensity and distribution of angina pectoris are the outstanding feature. Cactus grandiflora. Melancholy, fear of death, violent palpitation, sense of suffocation, cold sweat, inability to lie on left side, stitching pain though the heart with feeling that heart with feeling that heart in a vice; the pain radiates from the apex out to the shoulder and down the left arm; feeble pulse, vertigo, dyspnea and flatulence.
Crataegus. Very nervous and irritable, apprehensive, extreme dyspnea; rapid, weak pulse; precordial pain.
Lachesis. Patient becomes very talkative, Suddenly doesnt want to attend to business, violent palpitation with sense of constriction about throat so that they want no tight clothing about the neck and chest, syncopal attacks-always sleeps into an aggravation of all the symptoms.
Carbo vegetabilis is often very efficacious where its peculiar set of gastro-intestinal symptoms dominate the picture.
Lycopodium has many symptoms in the mental as well as gastro- intestinal sphere which frequently lead one to use it as the similimum in this condition with consequent gratifying results.
I know of nothing that will aggravate and prolong this condition more than an associated focal infection. It very frequently produces a toxic, multiple, intercostal neuritis. The patient quickly becomes convinced that the pain is “in his heart,” especially when it occurs in the left side of the chest, and he is further convinced of this if there is an associated brachial neuritis with the resultant pain streaking down the arm and forearm. I am always very careful to explain the nature of such pain and assure the patient that it is not in his heart. For such pain I most frequently employ either spigelia, ranunculus, colocynth, or ferrum phosphate, whichever seems most clearly indicated, and as adjuvant treatment, I order the affected nerve areas painted lightly with tincture of iodine and heated by the infra-red light.
I have spoken of these several remedies because they are the various ones which most frequently fitted the cases I saw. Please understand, however, that I propose that we shall use the particular remedy in the materia medica whose symptomatology best suits each individual case.
In conclusion let me point out that the facts presented here to do not represent hearsay-they have been one comes directly to grips with sick individuals and either sees results in the relief of symptoms and the patients return to normal health, or else regretfully experiences failure. DISCUSSION.
DR. HARLAN G. WELLS: Mr. Chairman, ladies and gentlemen, it is of course impossible for me in the brief time that is allotted to discussion, to go into the indications for the various remedies in the treatment of this very common condition which we call “neurocirculatory asthenia,” but I think Dr. Ferguson has done us all a very great favor, by impressing upon as the value of very great favor, by impressing upon us the value of the homoeopathic remedies in these cases.
The very common practice, when a patient of this type presents himself, is either to label him as a nuisance, and get rid of him, or to prescribe some compound that will put him to sleep, and we hope lull some of his sensations, so that we are no longer bothered with him. This procedure ordinarily fairly aggravates the illness from which the patient is suffering, and I usually have under my care one or two and sometime more, victims of this type of prescribing, whose nerves have been shot to pieces by constant drugging with barbiturates in a hopeless and futile effort to try to get rid of these neurocirculatory phenomena.
These people are sick people; their ills are not imaginary, and outside of the various corrections in their methods of living, and in their methods of working and other factors, the greatest, hope lies in the selection of the properly indicated homoeopathic remedy.
Sedatives, and hypnotics, and drugs of that type in the vast majority of cases, make these patients steadily worse, and if they continue them long enough we usually have a toxic drug picture to deal with in addition to the original illness.
Most of the remedies that Dr. Ferguson has referred to are remedies that I have used many times and can attest to their usefulness.
I am very glad that he has presented this subject from the standpoint of the clinician. The philosophy of medicine and of homoeopathy is a very fascinating subject and a very important subject, but after all the final test of any method of medical practice is the way in which it acts at the bedside. We may theorize all we please as to what a certain system of practice or a certain substance ought to do, but that actually counts, and what in my opinion does more for homoeopathy than anything else, is the actual curative results that we get with our patients. We may carry on campaigns of publicity, or skillfully conducted ballyhooed, but after all the greatest advertisement for an individual physician or for homoeopathy is the results that he can accomplish in actual practice, and I am very glad indeed that the Doctor has given us the benefit of his experience with his remedies. I think we need more of that sort of thing.