Chapter IV. Special Remedies for the Heart.
Pericarditis. For the acute pain in the heart, restlessness, fever, full, bounding pulse, aconite is the remedy. We will frequently need to combine it with that grand diaphoretic asclepias tuberosa, for it is quite as often indicated in this disease as in acute pleurisy. The prescription should read:
Rx Tr. Aconite, gtts. v.
Tr. Asclepias tub. ℥i.
Mix. Sig. Teaspoonful every hour.
Apply a warm flaxseed poultice over the heart. It feels good and helps to allay the inflammation. If there are stitching pains, made worse by motion, relieved by lying on the affected side, bryonia is the remedy. Dose, tincture bryonia, gtts. v, aqua, four ounces; mix, and give a teaspoonful every hour. From the very beginning of your treatment give kali mur. third decimal. Add ten grains to a cup of warm water and give a teaspoonful of this mixture once an hour. This remedy will often prevent effusion and it is the remedy for the absorption of exudates.
When the pain is very severe, shooting into the arm and neck, stitching pain in the left breast, dyspnea, patient can only lie on the right side, palpitation of heart, and the least movement produces a feeling of suffocation, spigelia is the remedy needed. Add fifteen drops tincture spigelia to four ounces of water and give a teaspoonful every hour. When complicated with rheumatism give three drop doses of tincture cimicifuga once in two hours. When cimicifuga is used as the principal remedy in acute rheumatism there is seldom any heart complications. This fact should be remembered by all physicians.
When the acute stage has passed the kali mur., third decimal, is to be continued. The following prescription will aid in removing the effusion:
Rx Fl. Ext. Jaborandi, ʒi.
Simple Syrup, ℥iv.
Mig. Sig. Teaspoonful once in two hours until profuse perspiration is produced.
The following diuretic and alterative mixture has rendered me good service in many cases:
Rx Tr. Phytolacca, ʒii.
Iodide Potash, ʒii.
Syr. Marshmallow, ℥vi.
Mix. Sig. Teaspoonful once in three hours.
Sulph. strychnine, one-thirtieth grain, should be given before each meal and at bedtime to keep up the vitality of the patient.
Hydropericardium. When there is a very slow pulse, skin apt to be of a bluish color, especially the eyelids, lips, tongue and nails, cyanosis, more pronounced when moving about, every third or fifth beat patient thinks the heart will stop beating. For this condition digitalis is the remedy. Dose, five drops in a little water once in three hours. When I prescribe digitalis in dropsy I always add about ten to twenty grains of cream tartar to an ounce of water, stir it up and then add the five drops of tincture digitalis. In my own experience, I have found that it increases the diuretic action of the digitalis. I have often increased the dose, one drop a day until the patient was taking ten or twelve drops of the digitalis at a dose.
When the difficulty in breathing is so great that the patient cannot lie down, puffiness of the hands and feet and also under the eyes, very thirsty, but water disagrees, sensation of sinking at the heart and pit of the stomach, urine scanty, dark colored, skin distended and glistening, bowels constipated, pulse slow, apocynum cannabinum is the remedy. Dose, five drops once in three hours. When the effusion is dependent upon the inability of the heart to carry on the circulation of the blood, there is edema of the ankles, heart's action rapid, pulse feeble, soreness in the uterine region, palpitation of the heart, tincture convallaria maj. is the remedy. Dose, five drops once in three hours.
When the lower eyelids hang down like bags, there is dropsy with absence of thirst, sensation as if every breath would be the last, skin very tender, sensitive to the touch, apis mel. is the remedy. Prescribe it as follows :
Rx Tr. Apis mel., gtts. x.
Mix. Sig. Teaspoonful once an hour.
I was called to see a case of dropsy of the heart, the kind that used to be called "Water round the Heart." It was a bad case, given up to die by her former physician. The patient was a middle aged lady; she sat propped up in bed, as she could not lie down; auscultation did not reveal any heart sounds; the heart seemed to be drowned in water. There was dyspnea and a very weak pulse. She seemed to me very near the end of life. I did not think I could do her much good, but as the family were anxious for me to do something I thought I would give her a little medicine to make her easier, for it did not seem to me that she could live until morning. I called for a glass, a spoon and a little water. I counted out sixteen teaspoonfuls of water into the glass, into which I put one grain of morphine and ordered a teaspoonful of the mixture to be given every fifteen minutes, until she was easier or slept. This is the way I prescribe morphine when I am forced to use it, which is very seldom. In my forty years of practice, I have not used a half drachm of morphine altogether. As I left the patient to return home the family wished me to call and see her the next morning, but for me I thought it would be a case of
"Ring the bell softly
There's crape on the door."
Upon visiting the patient the next day, I was met at the door by the husband with the report "the patient was better." I found that after she had taken two or three doses of the morphine mixture that the water began to pass off freely. Thus it was she got the primary stimulating effect of the morphine. I then gave her tincture digitalis as described above until I had removed all the water.
While it may be comparatively easy to remove the dropsical effusion, yet it is not so easy to prevent its returning. To effect a radical cure we must enrich the blood after removing the serum. Iron and helonias are the remedies that we will depend upon for this purpose. Give three tablets of the first decimal of ferrum every three hours and alternate with it three tablets of the first decimal of helonias every three hours.
Another case which I saw of "water round the heart" was a lady who had been sick for some time. Different doctors had treated her, but she was growing worse rapidly. It was very difficult for me to detect any heart sounds, and the heart seemed nearly drowned in the water. She could not lie on the pillow; had her head raised up. Her feet and legs were badly swollen. It was a desperate case but I determined to do what I could for her relief. I explained to the family that I proposed to remove the dropsical effusion. I had a woman used to nursing stay all night with her. I then prescribed the following:
Rx Podophyllin, gr. i.
Leptandrin, grs. ii.
Capsicum, grs. ¼.
Cream tartar, grs. xx.
Triturate them well together for one powder. Sig. Give one powder like this in a little sweetened water once in three hours until they began to operate freely on the bowels, then stop them. I instructed the nurse that the water would commence to run off before morning and that if the patient was faint to give her a little whiskey and aromatic spirits of ammonia (one drachm) in water. The next day I visited my patient and found her decidedly better. During the night the water began to pass off and at one time the patient said she felt as if "all the flesh was leaving her body." I gave this patient tincture digitalis for a little while, then the ferrum and helonias as given above and she recovered entirely. I have had many cases of this kind in my practice and frequently have taken desperate chances, as in such cases what is done must be done quickly and a cure of such a case will often make a doctor's reputation. We never know what we can do for the sick until we try.
Endocarditis. When this condition is complicated with rheumatism, headache in the forehead or top of the head, pain under the left nipple, and down the left arm, cimicifuga is the remedy. Put twenty drops of tincture cimicifuga into four ounces of water and give in teaspoonful doses every hour. When the pulse is full with hardness and tension, great muscular excitement, veratrum viride is the remedy indicated. Dose, tincture veratrum gtts. x, aqua ℥iv. Mix. Sig. Teaspoonful every hour. A full, bounding pulse, with fever, great restlessness, sharp cutting pain in the left side calls for aconite rad. Dose, tincture aconite gtts. v, aqua ℥iv. Mix. Sig. Teaspoonful once an hour. Kali mur., third decimal, should be given from the very start for that condition which favors embolus which acts as a plug. Place ten grains of it in a cup of water and give in teaspoonful doses every half hour.
When there is severe pain in the left side, palpitation, violent and visible blowing sound at the apex of the heart, spigelia is the remedy indicated. Dose, tincture spigelia, five drops every two hours.
Cramp-like pain in the heart, a feeling as if a great stone lay on the heart, calls for cereus bonplandi. Add twenty drops of tincture cereus to a glass of water and give a teaspoonful every half hour until the pain is relieved. As a preventive against future attacks of this difficulty give the third decimal calcarea flouride, three grains three times a day.
Myocarditis. When there is palpitation of the heart, vertigo, and choking in the throat and severe stitching pains in the cardiac region iberis is the remedy indicated. Dose, tincture iberis, gtts. xx; aqua, ℥iv. Mix Sig. Teaspoonful every hour. To encourage absorption of plastic exudates and emboli kali mur. is the remedy. Add ten grains of the third decimal to a glass of water, and give a teaspoonful every hour. Calcarea flouride, third decimal, three tablets three times a day, is valuable in the chronic form to correct the tendency toward fibroid degeneration about the heart.
When there is great difficulty of breathing, palpitation, rush of the blood to the head, Crataegus oxyacantha is indicated. Dose, ten drops tincture Crataegus once in three hours. The best local application over the region of the heart in deep settled inflammation of that organ is the compound tar plaster (irritating plaster). Apply one already spread (Merrill's). It will start up counter irritation over the region of the heart, relieve the pain and check the progress of the disease. It has helped me many a time to make a decided impression on the case by relieving the most urgent symptoms.
Hypertrophy of the Heart. When we realize the fact that hypertrophy or enlargement of the heart is really a chronic obstruction with nerve tension, it gives us the key to the first remedy, veratrum viride, to release the nerve tension and gradually remove the obstruction of the capillaries. Give tincture veratrum, first decimal, five drops every hour for three hours and then every three hours. You will notice less tension and a pulse which becomes more regular and stronger. When, from violent exercise, the heart has been strained, arnica third decimal is the remedy. Dose, five drops once in two hours. If caused by excessive use of tobacco cactus grandiflorus is the remedy—the heart feels as if it did not have room to beat, as if held by an iron band. Dose, tincture cactus grand. ʒss, aqua ℥iv. Mix. Sig. One teaspoonful once in two hours.
When there is a feeling of great oppression in the region of the heart, palpitation, dyspnea, constricting pains and tenderness round the heart, lycopus virg. is the remedy. Add twenty drops of tincture lycopus to a glass of water and give a teaspoonful once in two hours. If from valvular insufficiency give tincture collinsonia ten drops once in four hours. If complicated with chronic rheumatism give wine of colchicum five drops three times a day.
Dilatation of the Heart. Crataegus is the first remedy to be thought of in dilatation of the heart. When the first sound is absent, weak or prolonged, or misplaced by a murmur, the pulse being fast, often intermittent and irregular, you should give tincture Crataegus, ten drops once in three hours. When there is weakness, irregularity of beat, fluttering, palpitation, with feeling as if the heart would stop beating, phaseolus panus is the remedy. Dose, three tablets of the ninth decimal every twenty minutes until relieved. When the pulse is slow, great weakness, blueness of skin, especially of eyelids, lips, tongue and nails, pulse irregular and intermittent, digitalis is the remedy. Give the second decimal dilution, ten drops once in two hours.
When caused by grief, worry, long drawn sighs, sobbing, ignatia is the remedy. Tincture ignatia gtts. x, aqua ℥iv. Mix. Sig. Teaspoonful once an hour. When the right side is dilated collinsonia is indicated. Dose, tincture collinsonia five drops once in three hours.
Fatty Heart. When the pulse shows a weak discouraged feeling, loss of nerve power, give sulph. strychnine one-thirtieth grain before each meal and at bedtime. In anemic patients, complicated with diabetes or chronic rheumatism, vanadium will increase the appetite and strengthen the heart's action. Dose. Three tablets of the sixth decimal three times a day. When there is a shortness of breath, pain in the right arm, with obesity, I have used saturated tincture of Phytolacca berries (phytoline) ten drops before and after meals three times a day. I have treated patients who took on flesh so rapidly that they could hardly walk across the floor because of the difficulty in breathing thus produced. In a few days by taking the above remedy the flesh would be reduced and breathing become more natural. I believe it is the remedy needed for a "fatty heart."
A "Heart Remedy." I have used the following prescription for forty years in all heart difficulties where there was pain, palpitation and shortness of breath. It has done me good service.
Rx Tr. Castor.
Aromat. Spts. Ammonia, a. a. ℥ss.
Mix. Sig. One teaspoonful in one-third cup of water once in half an hour until relieved. One or two doses is generally sufficient. This remedy has helped me often in times of trouble. It is the remedy for palpitation of the heart. The more severe the pain in the heart the stronger is the indication for this remedy. It will relieve the pain. I was called to see a case where a man was suffering severe pain in his heart. The pain was so intense that it seemed as if he could not live very long. I diagnosed the difficulty as neuralgia of the heart. One or two doses of this medicine gave him quick relief, so much so that he left for his home in Brooklyn that night. Another similar case was a man who kept a summer hotel on Ipswich Bay, Mass. He had been treated by several physicians without relief. I diagnosed the case as enlargement of the heart. There was pain, palpitation and dyspnea. At times he would become unconscious. I gave him the above "heart remedy" as directed; also collinsonia, the first decimal, three grains four times a day. This patient recovered completely and was city marshal in one of the Massachusetts cities for some time. He lived for twenty years and finally died of pneumonia.
I have met with many cases of so-called "heart disease" in my practice. The physicians in attendance had told the patients that they were liable to drop dead any moment. I have treated such cases and cured them. Any form of heart disease can be cured except certain forms of organic disease.
Women will frequently come to me with palpitation, a little shortness of breath, a little pain in or around the heart. There is no real disease of the heart; they are mostly neurasthenics. The following prescription has cured very many such cases:
Rx Tr. Cimicifuga.
Tr. Pulsatilla, a. a. gtts. xx.
Mix. Sig. Teaspoonful once in two hours.
Angina Pectoris. When there is pain with tightness and constriction of the chest, tincture lobelia is the remedy. Dose, twenty drops every half hour until relieved.
When there is violent palpitation, shaking the whole chest, severe substernal pain radiating to the neck and arms, irregular pulse with tendency to syncope, palpitation, worse by the least movement tincture spigelia fifteen drops in half a glass of water is the indicated remedy. Dose, teaspoonful every half hour.
Crataegus is indicated when there is sudden and terrible pain in the left breast, pain radiating over the heart and down the left arm, patient is despondent, fearful of death. In such cases prescribe tincture Crataegus fifteen drops in a wine-glass of water. Repeat the dose in half an hour.
When the patient is pale, pulse small, wiry, anemia of the brain, glonoin is the indicated remedy. Dose, two 1/250 grain granules should be given once in fifteen minutes in a teaspoonful of water until the face is flushed and there is fullness of the head. My "heart remedy" is the medicine which I have depended upon in such cases (see Fatty Heart).
Exophthalmic Goitre. When there is a tumultuous action of the heart, eyes prominent, dyspnea, and oppression of the chest lycopus virg. is the remedy. Dose, tincture lycopus virg. fifteen drops three times a day.
Tincture fucus vesiculosis has cured cases of this disease. Be careful that you procure a reliable tincture. If it is a recent case give thirty drops of tincture fucus three times a day after each meal in two tablespoonfuls of water. If the case is chronic give one teaspoonful of the tincture three times a day, after each meal. Apply tincture iodine and tincture Phytolacca, equal parts, locally—by painting the enlarged growth—night and morning.
Weak Heart. The best remedies are digitalin and ferrum given in alternation as follows: Digitalin, third decimal, three tablets once in three hours; ferrum, first decimal, three tablets once in three hours. In those cases of rapid heart failure in pneumonia and typhoid fever, prescribe caffeine, two grains, every two hours. By the use of this remedy I have restored the force and rhythm of the heart in a short time. Phaseolus nanus is also indicated in a weak heart, when the pulse is scarcely perceptible and is irregular. Give three tablets of the ninth decimal once in twenty minutes until the heart beats strongly again. Glonoin is a quick stimulant to the heart in cases of faintness, wiry pulse and pale face. Dose, two 1/250 grain granules in a teaspoonful of hot water once in fifteen minutes until the beat becomes strong and regular. In a "crisis" when the vitality is low and the system fails to respond to the tonic action of your remedies give two granules of glonoin 1/250 grain once in three hours.
Valvular Disease of the Heart. Calcarea flouride, third decimal is the remedy to arrest early stages of valvular disease, and restore normal action of the valvular structures. It removes the fibroid deposit about the endocardium. Dose, fifteen grains in a glass of water and given in teaspoonful doses, of this mixture, hourly. When the patient awakes from a sound sleep, from a sense of suffocation, with a violent hard cough and difficult respiration spongia is the remedy. Dose, three tablets of the third decimal once an hour.
Dyspnea. This is a very troublesome symptom. For its relief I have used the following prescription with much benefit:
Rx Fl. Ext. Quebracho, ℥i.
Simple Syrup, ℥vii.
Mix. Sig. Teaspoonful once in two hours.
When there is a dry annoying cough, pulse low, weak, irregular, as found in the acute stage, naja tripudiant is the remedy needed. Dose, three tablets, sixth decimal, once in two hours. When there is failing compensation, urine scanty, great dyspnea, pulse irregular, headache extending from occiput around the temple, across the forehead to the eyes, adonis vernalis is the indicated remedy. Dose, tincture adonis five drops three times a day. Crataegus should be remembered here when the patient is gloomy, despondent, face pale, rush of blood to the head with much dyspnea. Dose, ten drops once in ten hours.
Arterio Sclerosis. Calcarea flouride, third decimal, is one of your best remedies in this condition. Three grains of this drug once in three hours. For the obstruction in the capillaries veratrum viride is indicated. Dose, five drops of the first decimal dilution three times a day to relax the capillaries. For the weak discouraged pulse, give one-thirtieth grain sulph. strychnine before each meal and at bedtime. When there is vertigo, a tremulous feeling, the heart is enlarged, its action irregular, the pulse has a shotty feeling, with some pain in the region of the heart, iodide arsenic is the remedy. Dose, three tablets of the third decimal once in two hours.
For the calcification of the arteries phosphoric acid dilute is the remedy. Dose, twenty drops in half a glass of water, teaspoonful once in three hours.
Palpitation of the Heart. In nervous hysterical women, we may have palpitation and copious urination. In this condition moschus is the remedy. Dose, five drops of the second decimal dilution every two hours.
In palpitation which is brought on by excessive tea drinking, china is the remedy. Dose, tincture china (cinchona) twenty drops in four ounces of water; of this mixture give a teaspoonful once in two hours. In palpitation of the heart from sexual excesses phosphoric acid is the remedy. Dose, add fifteen drops of the third decimal to a half glass of water and give a teaspoonful once in two hours. Palpitation from violent emotions, grief or worry, palpitation from the slightest exertion, kali phos., third decimal, is the remedy needed. Dose, three tablets once in two hours.
Diaphragmitis. Cactus grandiflorus is indicated when there is a feeling of constriction in the region of the diaphragm with sharp shooting pains. Add one drachm tincture cactus to four ounces of water and give a teaspoonful once in three hours.
Hiccough. Magnesia phos., third decimal, is a good remedy for this condition and will cure most cases. Place ten grains in a cup of hot water and give a teaspoonful every few minutes until relieved. A lump of sugar wet with vinegar placed in the mouth and allowed to dissolve will often give relief. In one case of an old lady to whom I was called I gave one grain sulph. morphia in sixteen teaspoonfuls of water, and directed a teaspoonful of the mixture to be given every fifteen minutes until relieved. It cured her. Tincture caulophyllum, ten drops once in a half hour is a good remedy. It may be given to children with safety.