Four Cardiac Cases with Clinical Observations

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Dr. Thomas Duncan ((1840-1902) briefly discusses four cardiac cases with clinical observations

A Case of Angina Pectoris

While a young physician thirty-two years ago I was called to a severe case of angina pectoris. I had heard of the case through a friend who had given me a clear picture of the attacks. The case was in a large boarding house where there were several young ladies— one of whom was especially interested in him. It seems that he would be taken and writhe in agony.  He said that his heart felt as if “gripped in a vice”’ and the only relief the allopathic physician could afford was by morphine, hypodermically, and then chloroform. The result was that he would be laid up for several days. Between the severe attacks and severe treatment he was fast being used up.

One day I rashly said that if there was any truth in Homeopathy that Cactus ought to control the attacks. This was welcome news. In a few days while vaulting over a low fence to get a child’s ball, an attack was precipitated and I was sent for in haste. My Cactus was a fresh, reliable preparation that I had procured on purpose and had it in my hand as I entered the house, ordering a half glass of water on my way to the room.  I found an athletic man being held on the bed by four persons.  His eyes were closed, face pale with a most anxious, fearful expression; head well thrown back and he was clutching at his left side (precordial region) as if to loosen the grasp of a monster. He was tossing from side to side as if in the greatest distress. I fixed Cactus 3x in water, and with the greatest difficulty succeeded in prying open his jaws sufficiently to get a teaspoonful in his mouth. By lifting the epiglottis I succeeded in getting part of it swallowed. I then let him inhale a little more chloroform. The former physician had resorted to it so often that the friends had learned how to give it. In a few moments he was evidently easier. I gave another dose which he swallowed readily. I stopped the chloroform and he relapsed into a sleep, taking his medicine however every hour for several hours. Next day he was up and came to my office to get some of that “wonderful remedy” that had stopped the attack so promptly. He had a slight attack the next week but did not have another for three months, when his supply of the remedy was exhausted. He was taking a dose daily when he left the city. I sent him some more of the remedy and a prescription.  He was then in Springfield, Mass. Six months thereafter I learned through his affianced that he had no more attacks.

Aconite Cardialgia

1 must tell you of another case that I encountered early in my career. A plump, close built lady with brown hair and eyes; when she took cold would have an attack of high fever with severe pain in the heart that would occur in paroxysms. Sometimes she would be insensible, and at other times would cry out in agony. She said it felt like a knife sticking her heart. After trying various remedies I finally found that Aconite would afford prompt relief when given early; later Bryonia was of service. She came to me because the allopathic plan of morphine and stimulants left her used up for days. For years she kept “that heart remedy” (Aconite) in the house. It would arrest the fever that followed a chill. She finally removed to Colorado and I learned that after passing the change of life she was free from these heart attacks. I was not then well up in diagnosis, and aside from a suspected slight hypertrophy could detect no other cardiac lesion. Her case had baffled several physicians. The attacks were called carditis. We often cure cases that cannot as yet be accurately diagnosticated.

Rhus In Heart Cases

Here is a case that has many points of interest. You see that he is large, of lymphatic, bilious temperament, and a war veteran. He had rheumatism in the army, as did most of the soldiers, until they learned to rest on the stomach instead of on the back while on the march. Walking, you know, produces spinal hyperaemia, so does the dorsal decubitus; if to this condition there is added a chill, an attack of rheumatism is apt to result. He complains now of pain and soreness in the muscles of the left shoulder, arm and back. I find that the pulse skips every few beats. The intermission is not uniform. I want you all to feel it and note how soft and compressible it is.  If it was bead like or staccatic we would infer that the aortic valve was diseased, but auscultation proves that they are sound, in fact all of the valves close properly. The inference is that the muscular walls are weak, possibly there is lack of nervous energy This is a Rhus case. You should be familiar with the effects of this drug upon the back and heart. Its pathology is that of spinal hyperaemia which explains its peculiar heart symptoms. Rhus made this case so well we lost sight of him after reporting decided improvement.

Organic disease of heart with sticking pains and soreness, numbness of left arm.  Chest and heart feel weak after a walk, trembling sensation of the heart.  Hypertrophy (uncomplicated) from violent exercise.  Palpitation violent when sitting still. Pulse accelerated, weak, faint and soft, trembling or imperceptible, sometimes seems quicker than the heart beats, irregular, affected by beer, coffee or alcohol.

Rhus may be employed in the various affections of the heart when complicated with measles, scarlatina or rheumatism. Palpitation worse during rest, stitching in the region of the heart, with painful lameness and numbness of the left arm, aching in the left arm, worse at night.

Palpitation. In nervous palpitation of the heart the poison oak acts well when the patient is better from continued motion or when the affection is occasioned by getting wet.

An Athletic Heart and Recurrent Bronchitis

This young man has an interesting heart. He tells us that he is an athlete and that he cannot practice athletics now on account of cardiac pain and shortness of breath. He has been fast and smokes a good deal. It seems he had an attack of some lung disease, was sick a long time and was sent to California where he was soon better and returned last spring well as he supposed.  He has caught cold and comes to us with a bronchitis. He takes cold easily and has had several colds — recurrent bron- chitis. You see that the bronchial inflammation is now at the bifurcation of the bronchi. We will give him Bryonia which stops the bronchitis and also helps the rapid forcible heart. On auscultation and percussion a slight hypertrophy is made out. It is traumatic. When we have removed the bronchitis we will devote more attention to the state of the heart. I wish you to note that the effects of running as in this case retards the pulmonic circulation, and gives us right sided hypertrophy.  That tends also to protract the bronchitis. You notice that all of his actions are nervous. Arnica will come in later. This case also emphasizes the bad effect of tobacco on the heart.

Excerpted from: Hand Book On The Diseases Of The Heart And Their Homeopathic Treatment  – Thomas C. Duncan, M. D., Ph. D., LL. D.. Published 1898.

About the author

Thomas C. Duncan

Thomas C.Duncan, M.D., Ph.D., LL.D. Consulting Physician to the Chicago Foundlings' Home.
Editor of The United States Medical Investigator. Member of the Chicago Paedological Society. First President of the American Paedological Society Author of: Diseases of infants and children, with their homoeopathic treatment. Published 1878 and Hand book on the diseases of the heart and their homeopathic treatment. by Thomas C. Duncan, M.D. Published 1898

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