In treating heart cases it is very important to be positive in selecting the remedy and then keep the patient on it, continuously. If not certain that the remedy selected is the correct one, the prescriber is apt to expect quick results, and not attaining them will be tempted to change. It is necessary to wait for evidences of improvement in such cases.
Miss C. M., 24 years.
Dec. 5, 1904. Gray hair (a family trait). Rheumatism in l.shoulder. Small goitre. Rapid pulse; mitral murmur, dilated l. side heart; 0. S. doctors have given no relief and no encouragement. Endocarditis. Weight in heart, when tired. Back, pain in region of heart. Ribs, sore sensation in cardiac region. Constipation: no action, no desire for evacuation. Tongue, sensation fullness, at root, from exertion. Vision dim or rather strained sensation in eyes. This is felt also in heart. Flatulence in stomach. Cold feet; when excited; during conversation feet become cold and head hot. Excitable, company excites. Must recline during mens. period. Aversion to meat. Leucorrhoea white. Disposition mild. Not sensitive to cold except extreme cold. Pulsatilla l0m.
Dec. 12. Additional symptoms: Respiration difficult, walking in the wind. Dislikes vinegar and pickles. Subject to hiccough. Darkness aggravates. Oppressed in the dark. Aversion to being touched. Improvement since last week: Bowels normal; Back pain imp.
During the next twelve weeks, prescriptions may be summed up briefly:
Jan. 5, PULS.: 1OM;
Feb. 23, PULS. 10M.
March 29, PSOR. 10m.
In that period of time the record includes these changes:
General feelings of improvement; menstrual periods more comfortable; eyes improved; aversion to meat, disappeared but returned; Stronger, rested in shorter time than formerly; craves outdoor air, which ameliorates; worse when warm spring weather appears; for several years has become worse at such time; not so much this year; very comfortable during mens. per but worse afterward.
March 29. Desire to remain indoors, now. The most prominent symptoms in the record during this period. Complaints from excitement. If she has a good time, becomes sick afterward; feet and hands cold from talking with company. Dreads the dark. Exhausted after shopping; from ascending the stairs; languid; drowsy in the morning; averse to rising. Heat of head and coldness of feet after reading to herself; Coldness after a bath; after a sponge bath; skin cold and clammy after a bath (weak heart). Coldness of feet end hips frequently. Heat in vertex when standing. Leads a sedentary life. Heart palpitation after exertion; heavy sensation around the heart; weakness sensation; conscious of it; pain under left scapula. Vertigo one day when shopping. Mens. per. late (5 days). Nosebleed before M.P. Right ankle swollen (old symptom of many years ago, returned). Larynx sensitive to touch. Neck, glands sore in right side. During much of this period the symptoms were turning toward Psorinum but so long as Pulsatilla benefitted her, it was not wise to change the remedy.
During the following seventeen months, she received the following prescriptions: June 2, PSOR. 10m.
July 24 and Oct. 20, PSOR. 50m.
Dec. 14 and Jan. 31, 1906: PSOR. cm.
April 10 and June 11, PSOR. Dm.
The most prominent symptoms during this period, varying in duration and intensity the symptoms that characterized her when there was any discomfort or disturbance-as found in the record are:
Slight swelling of the parotids. (New). Complaints from excitement; chilliness; as previously mentioned. Coldness, with desire for fire during wet weather; chilly when tired, followed by heat. Perspiration after bath; cold; back of hands cold. Aggravation from hurry. Very apprehensive; fear on the street; of being run over. Aggravation from exposure to sun. Wakens with a start; dazed when waking from sleep. Agg. from fright, cold afterward. Sleepy in evening; after dinner; with sleeplessness, formerly could sleep. Tired, aching in limbs and back; Amel. walking in open air. Mens. per. 5-6 days late; nosebleed when per. is due. Hungry before M. Chilly before M. L. arm lameness worse after a storm. Lameness in r. knee; in shoulder and foot. Bruised sensation in arm and hip. Scapulae, distress in; soreness sensation between scapulae. Mucus in throat; odour of catarrh in nostrils. Mouth, offensive breath in mornings. R. ankle swollen, first for short periods; then continually; pitting on pressure. This is frequently mentioned at the same time that the patient reports herself splendid and improving. Uncertain sensation when walking on the street, after the July dose. Heart: consciousness of it after dentistry; after mental or physical exertion; heavy after exertion. Pulsation quickened, heavy, after reading to herself a few hours; when excited. Strained sensation in heart; fluttering in heart; sore sensation in l. side. Restlessness referred to stomach; physical exertion occasions fatigue in the stomach. Cold perspiration while walking one day. Cold feet. Weakness from bodily and mental exertion. Flatulence in stomach. Cheeks hot when tired; head hot when excited; heat in body; after rapid walking; heat flashes from much walking, amel, reclining (May ’06). Agg. in hot weather, pressure in ears and throat. Neck discomfort from collar; fullness sensation. Vertigo.
Changes during this period of seventeen months include:
General improvement after Mar. 29 and frequently through the record. Stronger; can lift better. Symptoms all lessened. Face less purple than formerly. Gain in flesh on body and about waist. Mens. per. felt very well during period; very comfortable during period. M. on time; period one to three days early; mens. per. made scarcely any difference to her; attended social gatherings. Very active, following accustomed routine during mens. per. Has been shopping much, enjoyed social gatherings, talking with people, attended concerts, and enjoyed all without discomfort or the heat in head she used to have following such meetings. Nosebleed slight. Better in warm than in cold weather. Out nearly every day without fatigue (Nov.). Sensitive to heat (summer of ’06). Better when active; ameliorated by long walks; worked all day and was amel. by it. Pulse regular then rapid, otherwise heart appears normal.
It was about twelve months after beginning treatment that examination of the heart revealed no evidences of organic disorder, and since that time heart symptoms have been only functional.
After Psorinum ceased to give results, no distinctive symptoms developing, Naja was prescribed. In many cases of heart weakness in children, where there are no distinctive symptoms, cardiac murmurs and cardiac disturbances being associated with nervousness, Naja has cleared away the cardiac troubles and changed the patients to robust children. On that basis the prescription was made, in this instance.
In 1906 she received NAJA 10m, Aug. 15 and Oct. 18. NAJA 50m, Dec. 18 and Jan. 21, 07.
In Sept. ’06 she reported she felt the heart very slightly during the summer; she perspired freely and felt no fatigue; Desired open air, fond of walking in open air; chilly in morning.
Jan. 21, ’07 she reported having “taken cold” which she said was just such as she had when she began with “heart disease.” It was assumed to have been brought out by Naja and considered a good action.
In Feb’y. ’07 she reported having had considerable excitement one evening without any heart symptoms.
In March ’07 some liver disturbance with jaundice was the occasion of a prescription of NAT. SUL. 10m. The remedy was repeated in 50m potency and then there was no report for six months.
From Dec. 3 to June 20, 1908, there were two prescriptions of PULSATILLA cm, two of PULS. Dm, and one of mm, followed in Aug. by PSOR. mm.
During this period the record contains few symptoms, the chief ones being:
Nearly faints when first going to bed if reclines on back. Agg. in spring. Fear in dark, must have light in sleeping room. If wakens in the dark is frightened. Sleepiness. Nosebleed. Chilly before mens. per. Lameness l. arm. Heart: weakness sensation amel. by eructation. Soreness sensation in heart and fullness in throat, waking at night. Feet: puffy swelling. White line along upper lip.
The changes reported during this time are most interesting:
Generally feeling splendid. Fright when waking in the dark improved. Sleeps without a light in the room (June 1). Uses only summer clothing in cold weather. This is new for her and indicates how remedies will cure coldness. Mens. per. late. Reclines flat on back to rest, when tired.
1908. Well all summer; had long walks and much strength; Mens. per. normal, two days late.
After progressing, through a series of Pulsatilla, Psorinum and Naja, the patient turned again to Pulsatilla and that remedy carried her steadily toward health, leading again to Psorinum. Thus do the remedies take up the work, in alternating succession, while the patient advances steadily.
Frequent examination of the heart since the summer of 1908 have revealed no indication of organic changes, at any time.