USES OF DIGITALIS 427 



be given, however, repeatedly, in case of threatened heart 

 failure, by the subcutaneous method. The appearance of 

 indigestion, nausea or dulness, and a decided fall in the 

 pulse rate, should be a warning to stop the administration 

 at once. The best preparations are the tincture, infusion, 

 and fluid extract. The former may be injected deep into 

 the muscle to avoid abscess. 



Uses External. — Digitalis is occasionally employed as a 

 poultice of the leaves, applied over the loins to promote 

 diuresis, or in local inflammation, to contract vessels. 



Uses Internal. — Digitalis is a heart stimulant, although 

 sometimes classified as a heart depressant. It may, 

 however, exert a sedative eff'ect upon a weak, rapid, 

 irregular heart, by increasing the inhibitory and mus- 

 cular power. Digitalis is indicated: (1) In all conditions 

 where the heart is weak, irregular or intermittent, and the 

 circulation sluggish; (2) as a diuretic, chiefly in dropsy 

 secondary to cardiac disease, but also in that of renal 

 origin ; digitalis has also b.een used (3) as a haemostatic in 

 internal haemorrhage, and (4) to reduce temperature in 

 fever; but, in both of the last two instances, with question- 

 able advantage. 



1. In syncope following disease, shock, injury or poison- 

 ing (aconite), digitalis is invaluable when injected subcutan- 

 eously together with alcoholic stimulants. In acute diseases, 

 digitalis is one of the most generally serviceable stimulants. 

 The drug is peculiarly applicable in the second stage of 

 pneumonia, because it strengthens the right ventricle, forces 

 the blood through the obstructed lung, and prevents sys- 

 temic venous engorgement and arterial anaemia. In other 

 words, it equalizes the circulation. Moreover, in stimulating 

 the peripheral vagi, digitalis improves the tone of the 

 bronchioles and prevents collapse of the air vesicles, and, 

 by the same action, steadies the rhythm of the breathing. 

 The drug is likewise an efficient circulatory stimulant in 

 influenza of horses and distemper of dogs. Digitalis is 

 frequently prescribed in chronic bronchitis and emphysema, 



