The most constant symptom of Digitalis is to limit the action of the heart, and to render its beats slow and feeble; it is indicated by palpitation of the heart, orgasm of the blood, with great anguish, congestion of blood to the head, with loud noise and buzzing in the ears, dyspnoea, distress of breathing, suffocative paroxysms, irregular, intermittent, slow beating of the heart. This last paroxysm is eminently characteristic of Digitalis, and occurs very seldom in endocarditis. Hence it is that Digitalis will be of little use in acute rheumatism of the heart, but will be found an invaluable remedy in organic malformations of the heart. 4 particularly when symptoms of hydrothorax and urine with brick-dust sediment are present.

Arsenic is indicated by excessive palpitation of the heart, particularly at night,* with great oppression and anguish, irritated and frequent beating of the heart, small, scarcely perceptible or entirely collapsed pulse; the contractility of the heart is diminished or apparently destroyed, with frightful paroxysms of nightly anguish and danger of suffocation, which does not allow the patient to rest on his back. Arsenic is less useful in acute endocarditis than in pericarditis, or, particularly, in chronic affections of the heart, and in the asthma which depends upon organic diseases of that organ, and is accompanied with serous exudations.

Colchicum is a remedy of great importance; it corresponds to the cases where a joint was still affected shortly previous to the affection of the heart setting in, or where the joint remains inflamed during such an affection, with hot, painful swelling of the knee or some other joint, not admitting of the least contact, with general painfulness of the whole body and excessive debility, distressed and hurried respiration, panting and moaning, unequal, intermitting breathing, anxiety and oppression, stitches and tearing in the chest and region of the heart during an inspiration, with strong and fluttering beating of the heart, contracted, quick, very frequent pulse, tormenting thirst, profuse, sour-smelling sweats which do not afford any relief, scanty emission of bright-red, turbid, acid urine.

Nitrum is; like Aconite, indicated by a general vascular excitement, congestions of various organs, inflammatory and febrile symptoms. Violent palpitation of the heart, particularly when lying on the back, at night, with oppression and anxiety, obliging one to sit up in bed, full, hard and quick pulse, pressure on the chest, spasmodic constriction of the chest, with oppressive shortness of breathing and painful contractive sensation in the pit of the stomach, dry and hacking cough, with audible beating of the heart, violent stitch in the region of the heart, are symptoms characteristic of Nitrum.

* A characteristic indication for Arsenic is, when the palpitation sets in while the patient is lying on his back, and ceases on rising, - Hempel.

Spigelia is a chief remedy in affections of the heart, and is generally to be preceded by Aconite. It corresponds to endocarditis, with or without articular rheumatism, to pericarditis, and to chronic affections of the heart arising from inflammation. It is particularly useful in endocarditis rheumatica. It is indicated by the following symptoms: undulating motions of the heart, indistinct, continuous beating of the heart, tumultuous beating of the heart when lying or sitting, which is perceived by laying the hand flat over the heart, and is not synchronous with the beating of the pulse; spasms of the chest, suffocative complaints, tremulous sensation in the chest and temples, which is aggravated by motion, sensation as if the inside of the chest would be torn on raising the arms above the head or touching the pit of the stomach (Horn. Gaz., III.); purring noise during the beating of the heart, stitches in the region of the heart, tremulous pulsations of the carotids, great dyspnoea on changing the position of the body, bright-red lips and cheeks, which turn pale at every motion, elevation of the four last true ribs, of the sternum and xiphoid cartilage, displacement of the dorsal vertebras, (Arch. X.) audible beating of the heart, which causes a pain extending to the back, cutting pains from the heart to the shoulders, extending even up to the head and down the arms, dyspnoea increasing to actual suffocation, cutting, aching pain in the abdomen, in the region where the ribs commence, arthritic pains and stiffness of the joints (Arch. XVI. and Hygea XIX.); dull stitches recurring with pulse-like regularity in the region where the beats of the heart are felt, violent, audible beating of the heart, with anxious oppression of the chest, scraping in the throat, affection of the tracheal and bronchial mucous membrane, the beats of the heart are not synchronous with the pulse, purring in the region of the heart. The physical indications for Spigelia are: percussion-sound normal, or dull over a larger surface; increased shock of the heart; that portion of the wall of the thorax which corresponds to the heart, is visibly raised by the heart striking against it; the beats of the heart are not synchronous with the pulse; the sounds of the heart are increased, very loud, or accompanied with murmurs in different parts of the heart, or the murmurs are heard in the place of the sounds, both during the systole and diastole of the heart. Spigelia requires to be given in frequently repeated doses.

Aurum metallicum is an excellent remedy when rheumatic affections recur frequently, and finally shift to the region of the heart, in consequence of a cold, with distressing anxious pains hindering a recumbent posture, and obliging the patient to sit up; the pulse is irregular, frequently sluggish, intermittent; slight fever; oppression of the chest. After repeated doses, the rheumatism returns to the originally affected parts (Hygea XVIII.).

Asparagus is useful in chronic organic affections of the heart. It is indicated by indistinct stinging in the region of the heart, throbbing of the heart, perceptible to the hand and ear, and setting in after slight motion, irregular, quick, double beats of the heart, with anxiety, etc. It diminishes the violence of the occasionally recurring paroxysms.

Bismuthum causes strong beating of the heart, visible from a distance, frequency of the pulse, and congestion of blood to various organs. It is suitable for diseases of the heart arising from inflammation of that organ.

Other remedies, such as Nux vom. and Mosch., Mer-cur., Nitri. ac, Phosphor., Staphysag., Coccul. Tabac, Coff., Asa fat., act likewise upon the heart, but only sympathetically. These remedies do not cure inflammatory affections of the heart, but will be found useful in removing the anguish and palpitation of the heart of hysteric, chlorotic, etc. individuals. China, Ferrum or Arnica are likewise without avail in acute rheumatism of the heart.