THE common notion that disease of the heart is incurable should be in every way discountenanced by Homoeopathists. Many forms of heart disease are completely curable, and the sooner the popular ideas on the subject are corrected, the better it will be for those who suffer fro any kind of heart affection. It is true that old-established valvular disease cannot be altered, destroyed valves cannot be restored, but even in these cases much maybe done by remedies to restore the power of the heart when it is defective, and to bring about proper compensation, which is practically a cure.
In recent cases of valve affection it has frequently been my lot to observe the disappearance of all signs of disease under treatment. In my book on Rheumatism I have mentioned, among others, a case of this kind which particularly struck me when I was resident medical officer at the London Homoeopathic Hospital. It was that of a young girl who had a severe attack of acute rheumatism, with both pericarditis and endocarditis. Under treatment, the friction sounds of the pericardial inflammation quite disappeared, and when these had gone the bruits indicating endocardial mischief also subsided.
One of the chief difficulties in the treatment of endocarditis occurring in connection with rheumatic fever lies in the fact that there are so few symptoms indicating the mischief. Pericarditis has generally abundance of symptoms, hence it is a much easier matter to cure cases of this. On the other hand, there may be very extensive endocarditis and so sing be given except on physical examination. In such cases the only thing to be done is to take the totality of the symptoms and to prescribe accordingly.
If there are no symptoms elsewhere to guide, such medicines as have been found in practice or in provings to have an affinity for the lining membrane of the heart and arteries should be thought of, when the constitution of the patient and his previous medical history, with any former symptoms may have had, will severe to distinguish the most similar.
CASE I.-Quite recently a little girl, aged 5, came under my care in the Homoeopathic Hospital suffering from rheumatic fever, affecting a number of joints, and complaining of pain in her chest. I found extensive effusion into the pericardium, and a marked mitral systolic bruit as well. She had received Chelidonium and afterwards Aconite before I saw her, but without benefit. There was great irritability of temper, white tongue, heavy perspirations, and marked nightly aggravation of the symptoms, causing her to scream the greater part of the night. I prescribed Merc. viv. 12, and the symptoms at once abated.
The temperature fell to normal, the effusion disappeared, and in a few days the patient was convalescent. However, the bruit persisted. But there were no symptoms whatever. The child was, in all other respects, perfectly well. As her feet were somewhat cold and clammy, I prescribed Calc. c., but I could not trace any effect on the valve to this; and as the patient had no leave the hospital I was unable to follow the case further. Compensation, however, was fully established before the left.
During last summer a number of cases of endocarditis came under my observation in connection with acute fevers. There was at the time an extensive epidemic of German measles, and the first case I shall describe is that of a young lady aged nineteen who was one of its victims.
CASE II.-On June 15, I called to see Miss L., who had been somewhat ill for four days. I found the rash of German measles, sore throat, the right tonsil being enlarged. There was a cough, and she raised a good deal of phlegm. There was some fever. The monthly period was on at the time. The pulse was 72. On listening to the heart I found a systolic mitral bruit. She had cold, clammy feet. Under Belladonna 30 the symptoms of the fever left her, but the bruit remained. On the 22d June the bruit was audible in the mitral, tricuspid and left auricular areas when she was lying down, but disappeared when she sat up.
I gave her Spigelia 30, and in a few days the bruit became less distinct. She afterwards received Nat. mur. and then Arsen. for other indications; but on June 29th, after a restless night, hot and perspiring, the pulse was 84, the mitral bruit was very distinct, and heard in all the areas of the heart, and the patient felt “queer,” so I again gave Spigelia 30. Two days after this I found her feeling much better, and I could not hear the bruit. A few days later I listened again, but could hear nothing of it, so I let her leave town for the seaside.
CASE III.-About the same time i was attending another German measles patient, also a young lady, who developed in the course of it a similar affection of the mitral valve. Eventually this also disappeared, but as this case was more complicated, the attack having supervened on a long period of over-work and mental strain, much longer time was required. The medicine which had most effect on the heart symptoms in this case, was Baryta carb., which was given in two-grain doses of the 3x. The sensations she complained of were a strained feeling referred to the base of the heart and a sharp pain about the apex. The 3x appeared to have more decided action in this case than the 30th which was given first.
CASE IV.-Charlie W., aged 10, had an attack of English measles in May, 1892. I saw him on the 28th, and all the classical symptoms of the disease were present, and in addition, a mitral systolic bruit. There were no symptoms arising from the latter, and I treated the case according to the symptoms in the ordinary way. Under Bell. 30, Merc. sol. 30, and Sulph. 30, the disease ran a mild course, leaving the boy well, except for the bruit. On May 7th, as there were no symptoms, I put him on Lycopus virginicus 1 x which has a reputation in valvular disease.
I could trace no effect to this, nor to Spongia 30, with which I followed it. On 17th of May, taking into consideration that he came of a consumptive family on one side of the house, and guided by the crenated appearance of his teeth, which Dr. Burnett has shown is an indication for the medicine, I gave one dose of Tuberculinum (Heath) 200, and as he had cold, clammy feet, I followed this with Calc, carb. Under this treatment he made good progress, and on the 10th of June I ceased attending. The bruit was then inaudible when he stood up but could be heard if he lay down.
On December 14th I saw him again for something else, and had the opportunity of examining the heart. He told me he had no shortness of breath on running up stairs, and he could run as well as ever be could. The apex beat was felt in the fifth space, further to the left than normal, and the area of cardiac dulness was greater than normal. On standing, no bruit was audible; there was a little accentuation of the first second at the apex, and of the second over the pulmonary artery. On making him lie down I found that the bruit reappeared in all the areas, loudest over the apex, and the action of the heart became irregular.
I have not been able satisfactory to account to myself for this condition in which there is competence of the valve in the erect, and incompetence in the recumbent position, but it is a condition I have often observed. In one case, that of a child who bad at one time unmistakable mitral incompetence with attacks of violent palpitation and flushing of eyes and face following whooping- cough, I found, after some years, that the bruit could only be heard when she lay down; and still later it could not be heard at all. There was no anaemia in this case. Some defect of the posterior flap of the valve, or irregular action of the columnae cardiae may possible account for it.
CASE V.-On the 22d June, 1880, James T., a chimney-sweep, aged 44, came to my hospital clinic on the recommendation of a private patient of mine who had persuaded him to try Homoeopathy. When he entered my out-patient’s room it was easy to see he was exceedingly ill. Like most of his class he had led a hard, reckless life. He commenced chimney-sweeping as a tiny boy in the days when boys were sent up the flues instead of the machine- brushes now used. Naturally, he was a man of powerful physique; but now it had been with the greatest difficulty that he had succeeded in reaching the hospital.
He had the blurred, heavy look of countenance-a sort of indistinctness of features-often noticed in suffers from heart-disease. He had the blurred, heavy look of countenance-a sort of indistinctness of features-often noticed i suffers from heart-disease. He felt just as ill as he looked, for he afterwards told me that he never expected to reach home again alive.
Fourteen days before, he had taken cold form getting wet during a trip to Oxford on the river. This was followed by a cough with raising of thick phlegm, the cough being so painful that he had to hold himself, and this had continued. The chief thing he now complained of was a pain at the heart as if it were swelling up. The pain gradually moved down, and the night before his visit to me was in the left flank; then it moved up to the heart again. Sensation as if a big knife went through it, aggravated on taking for him so lie on the left side. Tongue white; appetite good, but he could not eat, because eating brought on the pain. Bowels confined, he had a choking sensation in the epigastrium, and a dizziness in the eyes. He was excitable.
