HOME-MADE TREATMENT. By C. F. Nichols, M. D.

Boston.

This is a neat little tract, uniform with the same author's successful "Sketches of Hahnemann and Madame Hahnemann," and "Homoopathy," and a hundred copies of either tract may be obtained for $2. This is intended for distribution to families as a kind of domestic homœopathy. High potencies are advocated, and alternation is condemned. THE EPIDEMIC OF 1878. By Ernest Hardenstein, of Vicksburg, Miss. 50 cents.

This is the most complete monograph on yellow fever from the homœopathic standpoint yet issued. Besides the report of the commission appointed by the American Institute, which it reprints, it contains much interesting matter on the theories, treatment, and statistics of the disease.

REVIEWS of the following books are being prepared: "Hering's Guiding Symptoms," "Marsden's Practical Midwifery," "Turnbull's Anæsthetic Manual," "Hughes' Therapeutics," "Stephen Smith's Operative Surgery," "Rosenthal on the Nervous System," "Delafield's Physical Diagnosis," "Transactions of American Institute of Homœopathy," "Marion Sims on Epithelioma of the Cervix Uteri," "Phillips's Materia Medica," "Haynes's Clinical Therapeutics, Part VII.," "Summer and its Diseases," and "Gallabin's Diseases of Women."

PERSONAL.

L. B. PARKHURST, M. D., B. U. S. M., 1879, is practising at Northampton, Mass.
M. S. HOLMES, M. D., same class, has located at West Waterville, Me.
E. B. SQUIRE, M. D., same class, has located at Lyndonville, Vermont.
W. O. HARDY, M. D., same class, has located at Grafton Centre, Mass.
GEO. W. WILDE, M D., B. U. S. M., 1878, has located at Ipswich.

HERBERT C. CLAPP, M. D., has removed from 544 Tremont Street to 16 Concord Square, Boston.

DR. J. S. SHAW has removed from 1222 Washington Street to 9 Dartmouth Street, first door from Tremont Street, Boston.

MARRIED, April 30, 1879, O. J. Travers, M. D., of North Brookfield, Mass., to MARY P. LYTLE, of Saratoga Springs, N. Y.

AMBROSE S. EVERETT, M. D., late Professor of Anatomy in the Homœopathic Medical College of Missouri, has removed to Denver, Col., where he has gone into partnership with Dr. J. M. Walker.

DR. HELMUTH has just returned from Paris, where he has had a delightful time. He has received the honorary degre of the Société Médicale Homœopathique de France. His instrument for carrying the elastic ligature was so much thought of by Colin (successor to Charriere) that he requested permission to make it and insert in his catalogue.

THE

NEW ENGLAND MEDICAL GAZETTE.

No. 10.

OCTOBER, 1879.

VOL. XIV.

SOME REMARKS ON THE TREATMENT OF FUNCTIONAL
AND ORGANIC DISEASES OF THE HEART, BY DR.
MEYHOFFER, OF NICE.*

TRANSLATED BY HERBERT C. CLAPP, M. D.

In the choice of remedies we shall follow the two principal indications suggested by the morbid conditions which we have just noticed, namely, to moderate the action of the heart on the one hand, and to increase its power on the other. To the first of these indications correspond more particularly Aconite and Cactus grandiflorus; to the second, Arsenicum, Digitalis, and Phosphorus. Nevertheless, the morbid conditions are not always so clearly defined; indeed, they are sometimes very complex, and demand medicines which will fulfil many other indications at the same time. In the multitude of this latter class of medicines, we shall confine our remarks to Coffea, Caffein, and the preparations of lime.

All the physiological experiments with Aconite show conclusively that this agent paralyzes the vaso-motor nerves, excites the action of the heart, and irritates, at the same time, its muscular fibres. The dilatation of arteries and capillaries, the elevation of temperature, the force and fulness of the pulse, the energetic impulse of the heart, the violent palpitation, and the præcordial anguish are effects of this plant so well known that we have no need of dwelling longer on the subject. What concerns us to state is this, that whenever we observe in a patient the phe

*Comptes Rendus Sténographiques du Congrès Internationale d'Homœopathie. Paris, Imprimerie Nationale, 1879.

nomena which we have just spoken of as produced experimentally by Aconite, we can in advance be sure of our power to lessen their intensity, and to make them rapidly disappear under the influence of this drug. We shall find in Aconite the great remedy against palpitation in plethoric youths and adults. It is no less powerful in aortic regurgitation with a strong and quick pulse, with excessive pulsation of the peripheric arteries and dilatation of the capillary network.

Its action is manifested not only in causing the rapid disappearance of palpitation and cerebral congestion, which so frequently accompany this lesion, but we shall also find that the diastolic murmur in the carotid (when it exists) has, at the same time, sensibly diminished. This transmitted murmur, noticed before the administration of this remedy, becomes sometimes almost imperceptible after the patient has taken three or four doses. By a dose we mean one or two drops of the first or second decimal dilution repeated every three hours.

All the aggravations caused by an endocarditis are under the control of Aconite as long as the arterial turgescence predominates; but when the heart itself is principally concerned, and the vascular disorders are only the consequence of exaggerated action, we shall have to resort to Cactus grandiflorus to establish the equilibrium.

Cactus grandiflorus.· This remedy, even now utterly unknown to allopathic physicians, plays a great part with us in the treatment of diseases of the heart. According to Rubini, who was the first to make us acquainted with it, the effect of this plant on the human organism is absolutely identical with that of Aconite. He attributes to it a power equal if not superior to the latter, in all inflammatory affections, and considers it an irritant of the heart itself as well as of its nerves. My experience with Cactus only partially confirms the opinions of Rubini. I have no doubt that it affects the muscles of the heart much more than any other organ or tissue, but it has no action on the nerves of the heart. The vascular dilatation and the force and fulness of the pulse which we notice in its pathogenesy are results of its primary effect on the cardiac muscular fibres, whose contractions are violent, throwing the blood with great force into the aorta, and yet we do not observe the same degree of vascular

excitement which we know that Aconite produces. This last fact we are more free to express, because we do not know of any remedy capable of moderating the action of the heart, superior or even equal to Cactus. I have made use of it with a success which has never failed me, in the idiopathic hypertrophies of the heart of young people, in all its excited actions, so frequent in the course of mitral and aortic insufficiency, and caused sometimes by endocarditis, sometimes by muscular effort. There is, indeed, this danger, that of allowing one's self to fall too easily into mere routine.

Cactus does not augment the heart's power, but it moderates and regulates its action, and in this way economizes it. It produces no effect on an enfeebled heart; secondary dilatation and cardiac cachexia come no more under its sway than they do under that of Aconite. This last remedy is even less often indicated than Cactus, but it sometimes prepares the way for it. The sensation of a constriction in the præcordia, with a feeling of a ring around the body and epigastric pulsation, are precise indications for the choice of Cactus. This plant, whose efficacy is so great in the treatment of organic affections of the heart, more than fills the place of the preparations of bromide of potassium and digitalis, which our allopathic confrères employ in such cases. It does not, like them, weaken the energy of the heart, but preserves it, and at the same time moderates it. The dose of Cactus ought to vary according to the urgency of the case; yet we shall rarely be obliged to give, to obtain promptly the desired effect, more than one or two drops of the second decimal dilution every two hours.

The dilutions of Coffea, which we prepare, and Caffein are to the nerves of the heart what Cactus is to its muscle. It has been clearly demonstrated by the experiments of Leven that Coffea exerts an elective and direct action on the nerves and ganglions of the heart, independently of the vagi and sympathetic. Its influence on the muscle of the heart is indirect, depending entirely on the excitation which it communicates to its network of nerves. In the same way the heart's quickened contractions and the more powerful intravascular pressure are accounted for. As a remedy, Coffea addresses itself to palpitation associated with a great flow of urine, caused by nervousness, One drop of the

third or sixth dilution is often sufficient to cut short one of these attacks of palpitation of nervous origin.

Although Caffein only acts as an indirect stimulant to the muscle of the heart, it has nevertheless been shown to be a powerful auxiliary to Digitalis in the treatment of asystolism. In cases of simple weakness of the heart, and even in passive dilatation and cardiac cachexia and fatty degeneration, this alkaloid does very good service, provided that it be given only in small doses. We have found two centigrams three or four times a day sufficient to obtain regular contractions of the heart and an increased flow of urine. (It was by means of this remedy that were removed the sleeplessness and oedema of the patient spoken of in Case No. III.) It also starts up the most energetic contractions of the heart in those attacks of syncope which last from six to seven hours, such as we have described in the case of the American lady (Case I.), and my friend Dr. F. (Case II.). In these two cases I gave one centigram ( of a grain) of Caffein every half-hour, up to the moment when the pulse came back, and after that at longer intervals. Now, if we can obtain from these small doses of this alkaloid such brilliant vital effects, is it not evident that by following the recommendations of Parrot, who advises us to prescribe from twenty to fifty centigrams of Caffein three or four times every twenty-four hours, we should soon end by exhausting the vitality of the nerves as well as that of the muscle of the heart?

Digitalis exerts the same influence on the muscular fibres of the heart that Caffein does on its nerves; that is to say, it paralyzes them. How does it happen, then, that allopaths use this plant and its alkaloid for a heart tonic, as well as we? To explain this contradiction, some physiologists affirm that Digitalis acts as a moderator of the heart's action, by means of its influence on the pneumogastrics; yet the experiments on which they rely are very contradictory, and far from justifying this view. The question is a very simple one. Digitalis in small doses increases the power of the heart, while in large doses it lessens it. Our allopathic confrères are so well aware of this that they prescribe by preference one or two granules of Digitaline, of one milligram (% of a grain) each, every day in asystolism, and when they desire to give larger doses, they give them at longer intervals. As for