In its physiological action the poison of _Latrodectus mactans_
resembles angina pectoris vasomotoria--a purely functional derangement.
The similitude of the physiological action to pure angina pectoris
corroborates the accepted pathology of the latter condition, because the
phenomena of _Latrodectus_ poisoning were educed from previously healthy
organisms, and in pure angina pectoris there is no pre-existent organic
change occasioning the attack. According to the accepted pathology, we
have in angina pectoris vasomotoria, sudden spasms of the arterioles;
from this an increase of the arterial tension; to overcome this is more
forcible and rapid action of the heart; as the arteriole spasm persists
and doubtless deepens in intensity, distension of the left ventricle
follows, and from overdistension the agonizing breast-pang, and even
death from stoppage of the heart's diastole. But we must include another
element--spasm of the coronary vessels. "When there is a sudden rise in
the blood-pressure in the arteries, due to vasomotor spasm of the
peripheral systemic arterioles, and the heart-walls are strong and well
nourished, palpitation is evoked; when the coronary branches are
involved in the vasomotor spasm then angina is produced, and the
heart-walls, acutely distended with blood, can scarcely contract in the
face of the opposition presented to their contraction by the high
arterial tension. When this sudden systemic arteriole spasm extends to
the coronary vessels in a heart whose walls are diseased, a fatal attack
of angina with the heart full of blood may be induced. The danger
increases with the extent of the structural degeneration of the
heart-walls. Sudden rises of blood-pressure in the arteries will tax
hearts in their textural integrity, and lead to painful distension; such
sudden demands on decayed hearts lead to agonizing angina pectoris, and
the sense of impending dissolution is frequently followed by sudden
death."
Spasm of the arterioles and coronary vessels, rise of blood-pressure in
the arteries, embarrassed action of the heart, and painful distension
are just so many consecutive links in the phenomena produced by the
poison of _Latrodectus mactans_, as Cases I and IV amply testify.
The spider poisons are akin to the serpent poisons in their property of
producing a disorganization of the blood. In Case I, thin and florid
non-coagulable blood continued to ooze from the cut surface despite the
application of tannin. It may be a question whether this condition of
the blood is directly toxicological, or a pathological result of stasis
in the peripheral vessels. I incline to regard it as due to the latter
condition, and I believe this explanation also holds good in the case of
serpent poisoning.
The haemorrhage recorded in Case I was of gastric origin; splenic
congestion existed, and the vasa brevia--branches of the splenic
artery--gave way under the pressure. I once met a similar haemorrhage in
a case of intermittent fever in a child, and I recorded the fact as a
possible hint for the applicability of _Latrodectus mactans_ in a
similar condition.
In all the year that the stray copy of the old magazine was in my
possession I felt it a duty to write up this remedy. I have done it
lamely, but as well as I was able. Reader, where my duty ends yours
begins. May you discharge it more worthily than I.
(There have been a number of cases reported in which
_Latrodectus mac._ acted as Dr. Jones predicted; from
them we select the following by Dr. E. H. Linnell, _North
American Journal of Homoeopathy_, December, 1890):
S. L. G., a man fifty years old, of bilious temperament, a dentist by
profession, had slight attacks of angina after severe exposure and
overexertion during "the blizzard" in March, 1888. He did not consider
them of sufficient importance to consult a physician about them, but
some months later he had a suppurative prostatitis, which was followed
by considerable prostration, and the attacks of angina became very
severe. I never could get a satisfactory description of the character of
the pain, and I never saw him during a paroxysm. The pain was brought on
by exertion of any kind, and was especially frequent soon after dinner.
The pain was sometimes felt in the left arm, but was usually confined to
the cardiac region. I once or twice detected a slight aortic obstruction
sound, but aside from this failed to find any evidence of organic
disease. The usual remedies gave no relief, but _Latrodectus_ [Latin:
ezh]c was of great benefit. Under its use the attacks gradually became
less frequent and less severe. He has taken no medicine now for at least
six months, and he tells me that although he occasionally has a little
reminder of his former trouble, the attacks are so slight that he pays
no attention to them. I have given the remedy in another similar case,
with even more gratifying success. The attacks were very promptly
arrested and have not returned, although nearly a year has elapsed. I
think we have in this remedy, to which Dr. S. A. Jones directed
attention in one of the issues of the _Homoeopathic Recorder_, a very
valuable remedy in this painful affection. It is probably, as Dr. Jones
suggests, in angina pectoris vasomotoria that it will be found
especially serviceable.