Diagnosis

Intense and terrible pain in the region of the heart, coming on in paroxysms, and extending over the chest, neck, and arms, and accompanied with sensation of fainting. The pain varies in intensity, the breathing may be apparently arrested, or be exceedingly difficult and attended with moaning; the pulse is generally small and feeble, and during the paroxysm, the face and extremities may be covered with a cold sweat.

Causes

It may arise from abuse of spirituous drinks, errors in diet, dyspepsy, rheumatism or gout, and is not unfrequently connected with organic disease of the heart.

Treatment

During the paroxysm the patient should remain perfectly quiet, in an erect position, and be relieved from all external pressure.

Arsenicum

This is a valuable remedy, where the patient is unable to breathe, except with his chest bent forward; oppressive stitching in the region of the heart, with fainting and anguish; the attack is renewed or aggravated by the least motion.

Digitalis is indicated where the action of the heart is violent, or where the disease sets in suddenly, and there are present, drawing or spasmodic pains in the left chest and sternum, the neck and arms, and sometimes a deathly anguish.

Belladonna

Difficult and hurried respirations with moaning; tensive shooting or pressive pain in the vicinity of the heart; tremor of the heart, with anguish and an aching pain.

Iihus

Violent pulsative stitches, in the region of the heart, sometimes with painful lameness and numbness of the left arm; palpitation of the heart; difficulty of breathing.

Spigelia

Great difficulty of breathing. Dull or oppressive stitches in the region of the heart; cutting, lacerating, or tensive and drawing pain; violent palpitation of the heart.

If other remedies are required, Iodine, Mercury, Phosphorus, and Veratrum. See also "Facial Neuralgia," and "Materia Medica."

Dose

Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose; or six globules, or a powder on the tongue. In violent paroxysms, give every half hour or hour, gradually increasing the intervals as the pain abates.