ACCUMULATION OF DIGITALIS IN THE SYSTEM. 571 
ence on the nerves of respiration it affords much relief. My in¬ 
tention, however, is not to speak of the general action of this 
drug, but its particular and occasional one. This I shall do by 
putting a question, and following it up by an answer; hoping 
thus to induce others to give the result of their experience. 
Does not digitalis occasionally accumulate in the system, and, 
by so doing, cause effects that are both unexpected and different 
from those ordinarily induced by it ? 
I am compelled, from having a little carefully watched the 
effects of this drug, to reply in the affirmative. If this be cor¬ 
rect, it only affords another proof of the necessity of circum¬ 
spection in the employment of remedies; for a medicament may 
be never so valuable, and yet, where a want of judgment is, it 
may prove injurious: but who on that account would condemn 
and discard it ? 
Medicines are at best but relative agents, their effects depend¬ 
ing in a great measure upon the state of the body, condition, &c. 
of the patient. Disease, if it does not originate and determine, 
at least modifies their action; and it is only when the “ harp of 
a thousand strings” is untuned—when seemingly a displacement 
of some of the wheels of the complex machine has taken place— 
that they can be said to be of real use. Experiments with them 
at other times often dead us astray, and our deductions are 
frequently incorrect; they should, therefore, be accepted with 
caution. They may serve as guides, but certainly they do not 
merit our implicit confidence. 
Among the more common indications of this derangement in 
function is a disinclination for food. Hence it is, that this, which 
is a general attendant on digitalis after it has been given in re¬ 
peated doses, is often passed by unnoticed ; and the heart’s 
action not being yet perceptibly under its control, another and 
perhaps another dose of the medicine is administered ; when, all 
at once, we have produced a quick and an irritable pulse, accom¬ 
panied with considerable depression of the vital energies, and 
followed by a relaxed state of the bowels : or, when the quantity 
given has been large, a state of nausea supervenes, with its 
concomitants, loathing of food, the head depressed, increased 
secretion of saliva, and chilliness of the surface of the body. The 
pulse is feeble and tremulous, and suddenly falls to, sometimes, 
even below the natural standard, the lining membrane of the 
nostrils having a blanched hue. These symptoms generally 
disappear with a softening of the faBces, by which means I opine 
the agent is expelled ; at least, these are the results I have more 
commonly witnessed. 
In inordinate doses, digitalis appears with one fell sweep to 
