The general treatment of the consequences of valvular lesions is based on the general indications (1) of favoring compensating hypertrophy, and (2) of preventing dilatation and cardiac weakness. The first indication — namely that of regulating compensating hypertophy by (a) not allowing it to progress too rapidly, or (b) to progress too slowly. The medicines which appear to me to possess some power to retard excessive hypertrophy, are : Veratrum viride, Erythroxylum coca, Cactus, Lycopus vir., Kali bromatum, Aurum, and Glonoine.
Veratrum vir., given in doses of 1/10th or 1/100 of a drop, regularly every three
or four hours, for days and weeks, will lower the abnormal force and frequency of the heart’s contractions. It matters not whether it acts on the cardiac ganglia or directly on the muscular substance of the heart, this retarding action takes place quietly and without producing any functional disturbance if the dose is kept within the proper limits. As soon as the force of the heart becomes normal, the medicine should be suspended. There are cases where Aconite can be substituted for Veratrum v.
Coca has a similar action, but should not be used so continuously. Its sphere is rather in those conditions of cardiac irritation brought on by excessive mental or emotional excitement or physical exertion. In such cases a few drops of the tincture or of the first decimal dilution calms the palpitation, when its use should cease. Coffea (caffeine is one of the constituents of Coca) acts quite as favorably in some cases, in the third (x) dilution.
Lycopus virginicus has a sedative effect on the cardiac ganglia or vaso- motor centre, and a calming action on the heart. Its use can be continued for a long time, if necessary. Its action on the circulation in Basedow’s disease is proof of its power in hyperstimulation of the heart. When the rapidly progressing hypertrophy results in causing pulmonary haemorrhage, this remedy is doubly indicated. The dose should range from 10 drops of the 1st dilution to 10 drops of the mother tincture.
Cactus grandiflora or Cereus bonplandii are both indicated in too rapid hypertrophy, where the force of the contractions is too forcible for the valvular lesion, and when the blood-current is forced too strongly into the brain and lungs, inducing cerebral and pulmonary congestion and haemorrhage. Its well-known characteristic symptoms are the guides to its use.
Kali bromatum is best indicated when the distant and reflex irritations (intestinal, ovarian, and cerebral) excite the heart, causing it to flush too intensely the arterioles. A few doses of 5 to 10 grains, repeated every two or three hours, will have a very beneficial effect.
Aurum mur. is recommended by Klapka for ” venous stasis due to palpitation,” or the “congestion of the brain” due to the same cause. When such conditions occur in mitral disease (or functional disorder), Aurum is doubtless useful. It primarily excites and intensifies the force of the heart’s contractions, and flushes with an active arterial congestion all the organs and tissues of the body. Its recorded symptoms give us a complete picture of this condition. The 3rd dilution is the best preparation in such cases.
Glonoine is to aortic valvular diseases what Aurum is to mitral lesions. It is primarily homoeopathic to active arterial congestion of the brain, with dyspnoea, great pain in the chest and heart, almost equal to angina pectoris. I shall allude further on to its use, as secondarily indicated (falsely called antipathic). Belladonna occupies a position between Aurum and Glonoine.
It is evident that all the cardiac tonics are exquisitely homoeopathic to rapid hypertrophy, but I confess that I have never been able to observe such curative action as we would naturally look for from the one chiefly indicated, namely : Digitalis.
Convallaria, Adonis, and Caffeine have not been sufficiently tested in attenuated doses to enable us to judge whether, like Digitalis, they will fail us in excessive force of the heart’s action.
Climate — In the condition of the heart above described, when the blood current is too strong, also in true hypertrophy, it is often necessary to advise the patient to change climate. I have often found such patients to do well in a southern location, between latitude 25° and 35°, where the altitude is low and the atmospheric pressure is high enough to counteract the increased blood pressure.
The second indication in the treatment of valvular disease of the heart is to assist the heart in its attempts to accomplish hypertrophy without dilatation, or complete compensation. Fothergil clearly explains how unaided nature often brings this about, namely : “Distension, which involves the elasticity of the muscular fibre itself, that is, extending beyond normal distension till the full length of the fibre is reached, and involving the secondary elongation of the fibres, or their elasticity, creates an impression in the cardiac ganglia. This is quite in accordance with what we know; it is merely the normal stimulus in excess.
From recent experiments we learn that the heart possesses a sensory nerve, a fact which we would conjecture from the pain accompanying heart affections, and especially acute ones, and this nerve has been found to be a vaso-inhibitory
nerve, i. e., it arrests vaso-motor nerve action, and dilates the peripheral muscular extremity of the circulation, the arterioles. Thus is not only the tension of the arterial system lessened, and with it the opposition offered to the heart’s more completely emptying itself at each systole, but this affects the arterioles of the coronary circulation, and thus a broader and more rapid stream of blood is furnished to the heart itself, and so leads to hypertrophy.”
But, unfortunately, nature alone rarely accomplishes complete compensation, and when she fails, we get the two conditions described by Traube : (a) ” hypertrophy with dilatation, or incomplete compensation;” and (b) “simple dilatation or no compensation.”
I have already given the treatment of incomplete hypertrophy. I will now give the treatment of that most common sequence of valvular lesions — simple dilatation or no compensation. The condition of the muscular fibres of the heart’s walls, in this condition, is one of weakness and flaccidity. The heart itself is not nourished, because it is actually starved. This may arise in some cases from an impoverished
condition of the blood, and our first duty is to see that it is enriched by blood-making food, proper exercise in the open air where there is an abundance of oxygen and no malaria. If this can be done, we shall rarely be obliged to use Iron, Copper, Arsenic, and other haematic medicines.ted from: A System of Medicine Based Upon the Law of Homoeopathy Edited by H. R. Arndt, M.D.