USES OF DIGITALIS 451 



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 effect upon a weak, rapid, irregular heart, 

 by increasing the inhibitory and muscular 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 been used 

 (3) as a haemostatic in internal haemorrhage, and (4) to re- 

 duce temperature in fever; but, in both of the last two in- 

 stances, with questionable advantage. 



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

 oning (aconite), digitalis is invaluable when injected sub- 

 cutaneously together with alcoholic stimulants. Its action is 

 slow, however, and in emergencies it should be reinforced 

 by the use of strychnine or adrenalin. 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 sj:rengthens the right ventricle, forces 

 the blood through the obstructed lung, and prevents sys- 

 temic venous engorgement and arterial ansemia. 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. 



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