■November 4, 1871.] 
THE PHARMACEUTICAL JOURNAL AND TRANSACTIONS. 
307 
results, when aconite had been given, and the ventricle 
had become gradually more and more distended, and its 
contractions more and more imperfect,—each contraction 
merely expelling a small quantity of blood off the top of 
the distended ventricle, the contractions becoming slower 
and slower, and less and less perfect, until a condition of 
advanced dilatation had been artificially produced; and 
even when the heart seemed to have given up all action, 
and remained in diastole, distended with blood and inert. 
"When all action had apparently ceased, the first effect 
was to produce an imperfect contraction at long inter¬ 
nals ; then the intervals became shorter and the contrac¬ 
tions more complete, some irregularity both as to time 
and amount of contraction being observed. Slowly and 
gradually, however, the distended ventricle recovered 
itself under the action of digitalis, the contractions being 
more rhythmical and perfect, and the distension less and 
less pronounced, until a return to normal contraction and 
■distension was brought about. If the administration of 
'digitalis were then continued, the same appearances were 
brought out as when no aconite had been previously 
given. This interesting experiment was frequently per¬ 
formed before other medical observers, and can be readily 
repeated. In all the experiments the ventricle was the 
most affected; in the frog, where there is only one ven¬ 
tricle, the auricle could only remain distended behind it, 
incapable of getting rid of its contents into the firmly 
'Contracted ventricle in front, and of course it could not 
•contract unless its contents could be disposed of: if the 
venous sinuses behind were pi'icked, as in the case of the 
minnows, the auricles soon became contracted. As re¬ 
gards the effects upon the rhythm, the general results 
may be stated broadly thus: at first there were occasional 
.slow beats, interposed without any exact order; and then, 
•as the effect became more marked, the slow beats pre¬ 
ponderated, until the contractions were only occasional 
before complete cessation in systole. During an experi¬ 
ment on a dog by Brunton and Gamgee, a temporary 
murmur was observed, which they concluded was due, 
••and apparently with good reason, to an irregular action 
of the musculi papillares, producing imperfect closure of 
the mitral valve. 
In these experiments on the frog, sometimes the ^tinc¬ 
ture of digitalis was used, and at other times the infu- 
•sion. In some instances, a solution of digitalin was used, 
but its effect in producing increased contraction was 
•certainly not so marked as when a preparation was used 
which contained the other principles. It is not intended 
that this statement should convey the impression that 
"there exists any good reason for supposing that digitalin 
is not the active principle in digitalis; but such is the 
writer’8 experience. 
Hilton Fagge and Stevenson found that, sometimes, 
"the ventricle makes only one pulsation for two of the 
;auricle, the number of its contractions being therefore 
lessened one-half (Transactions of the Royal. Society, 
May I860, Conclusion 3 ). Reid seems to think that 
sometimes more than one auricular systole is necessary 
bo produce such ventricular distension as would excite 
contraction. This seems in accordance with reason and 
fact. 
Antidotes .—In cases of poisoning where it is known 
“that the symptoms arise from the use of digitalis, and 
not from attacks of cardiac syncope, the use of agents 
must be resorted to w r hich are known to paralyse the 
heart,—for instance, aconite. Although in the experi¬ 
ment on the frog, the action of aconite on the heart after 
the poisonous effects of digitalis had been induced was 
far from being so marked as when digitalis was given in 
.-aconite-poisoning, aconite might prove of service as an 
antidote to digitalis. From the action of the Calabar 
■bean, as described by Dr. T. R. Fraser, of Edinburgh, it 
is highly probable that it would act beneficially in the 
excessive action of digitalis. This leads the author to 
^consider the question of agents of similar action. 
Drugs of similar Dower .—The whole question of agents 
acting upon the heart so as to increase its power of con¬ 
traction is comparatively new. With the exception of 
digitalis we are, generally speaking, scarcely acquainted 
with their names. The agents are either entirely new, 
or nothing has hitherto been known of their secondary 
effect upon the heart. The list of them is a short one, 
and will not take up much space in the enumeration. 
Thus Dr. Clifford Allbutt has advocated the use of Vir¬ 
ginian cherry-juice ( Prunus J irginianci ) in cardiac affec¬ 
tions ; Dr. John Harley has investigated the action of 
belladonna; Dr. Braidwood the action of dajasck, or 
arrow-poison of Borneo ( Tanghanina venenifera ) ; Drs. 
Hilton Fagge and Stevenson have investigated the action 
of the Sc ilia maritima and the Uclleborus viridis; and 
Leven has investigated caffein and them. Of these, the 
writer has only experimented on digitalis, belladonna, 
and caffein. There is thus plenty of opportunity for in¬ 
vestigating further the action of these drugs, and adding 
to what we already know of their action; while there is 
a ground for hope that to this list may be added new 
agents more certain, more effective, and more manage¬ 
able than those we as yet possess. Dr. Fothergill con¬ 
siders that by thus treating digitalis as a member of a 
class of agents, it will much facilitate the investigation 
into the usefulness, or uselessness, of a drug as a cardiac 
neurotic. It is obvious that other agents which increase 
the ventricular contraction and bring the heart to a 
standstill in systole, must necessarily possess a thera¬ 
peutic value allied to that of digitalis. In prosecuting 
such an inquiry, it will be easy to ascertain to what ex¬ 
tent the action is common to that of the whole class, or 
in what it is singular. This grouping of agents as to 
action will assist us in aggregating a number of agents 
with either a primary or secondary effect upon the heart; 
in time this will constitute a group, and in practice the 
remote effect of an agent upon the heart will, be taken 
into consideration in the choice of therapeutic agents. 
It is only by the grouping of agents and then testing 
them by clinical experience and physiological experi¬ 
ment, observing the successes, the failures, and their 
causes, that we can expect to emerge from our present 
therapeutical chaos. Thus, under our old plan of em¬ 
pirical testing of agents, colchicum has six or eight times 
been removed in and out again of our Pharmacopoeia. 
The same, to a less extent, has occurred to numerous 
other agents of no trifling activity. It is obvious that 
the use of these agents has been conducted on. nothing 
approaching a law, else some definite conclusions one 
way or the other must have been arrived at. V ithout 
some definite idea of what it is we want exactly to. at¬ 
tain, and by what action our agent is likely to. achieve 
the desired result, we cannot be said to do anything more 
than—to nsfi a vulgarism— t£ make shots. dhe experi- 
than—to use a vulgarism- . . 
ments of Crum Brown and Frazer into the physiological 
and chemical agency of drugs, and Broadbent s valuable 
speculations on chemical tension, and the question of the 
retardation or aiding of oxidation as a mode of explain¬ 
ing the action of many agents, are steps in the right 
direction, the value of which we are scarcely yet m a 
position to correctly estimate. 
The Use of Digitalis .—Like other vegetable substances, 
digitalis is prepared for use by either tincture, infusion, 
extract, or separation of the active principle digitalm. 
The extract is little used. The tincture is the most con¬ 
venient form ordinarily, but throws down a dark green 
precipitate with iron, which detracts from its desirability. 
For general use, it can be given along with the ammomo- 
citrate of iron, or, still better, the potassio-tartrate. It 
is better kept in a dark cupboard or wrapped m a dark 
coloured paper, as light is supposed to act deletenously 
upon it, weakening it and lowering its activity. J-he 
infusion is a good preparation tor use along ruth potash 
or diuretics, and is conveniently added to vegetable in- 
fusions. Digitalin in solution may be the most ele 0 ant 
form, and perhaps maybe found ultimately to.be t e 
most exact form for accurate administration , but in soma 
