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Materia Medica Viva Volume 6 – page 1239

Rhus-t. does not hold and eventually the heart gets involved. A typical case (Journal of Homeopathic Clinics, 1870): ‘Rheumatism affecting all the joints of the extremities with a great deal of pain, stiffness and swelling; worse in the evening and again in the morning on first rising; aggravation while at rest, on beginning to move, and from a change of weather, especially if the change be a cold, damp one. Amelioration from continued but gentle motion.’ Ultimately the heart gets involved and the characteristic constrictive pains that require Cactus ensue. Such a case can look like Rhus-t. or Tuberculinum, but the final involvement of the heart is the determining factor in favour of Cactus.
When the organism is exhausted from a severe infectious disease and eventually the heart shows symptoms of failing. A feeling as if the heart will stop beating every time the head is raised from the pillow is characteristic.
Cardiac asthma, when the patient cannot lie down on account of the oppression and the excessive secretion of mucus. The attention of the patient is focused on the heart symptoms, of which he constantly complains. He has rattling of mucus with dyspnoea, which causes him great anxiety. He has a raw feeling and a sensation of constriction in his chest as if it gets tighter and tighter until he cannot take a breath. There may be no cyanosis and no great restlessness. There is also a possibility of hypostatic congestion of the lungs due to cardiac weakness. The patient is unable to lie down and must sit up in bed. ‘Could only breathe with shoulders elevated and lying on the back. ’ (Hering)
Cactus may congest the brain in such a way as to create a situation simulating a brain stroke, most probably brought on by a constriction of a vessel in the brain. While this is happening the patient loses the ability to move. A partial blindness and difficulty in speaking may ensue, and his walking becomes unsteady. His face becomes red simultaneously with a sensation of constriction about the heart.