DIGITALIS GROUP. 
§§ 55 2 > 553-] 
445 
of digitalis used in pharmacy, there is still greater difficulty—a difficulty 
not arising merely from the varying strength of the preparations, but 
also from the fact of the vomiting almost invariably excited by large 
doses. Individuals swallow quantities without death resulting, simply 
because the poison is rapidly expelled ; whereas, if the oesophagus were 
ligatured (as in the experiments on the lower animals formerly favoured 
by the French school of toxicologists), death must rapidly ensue. The 
following table is a guide to the maximum single dose, and also the 
amount safe to administer in the twenty-four hours in divided doses. 
As a general rule, it may be laid down that double the maximum dose is 
likely to be dangerous :— 
TABLE SHOWING THE MAXIMUM SINGLE DOSE, AND MAXIMUM 
QUANTITY OF THE DIFFERENT PREPARATIONS OF DIGITALIS, 
WHICH CAN BE ADMINISTERED IN A DAY. 
Single Dose. 
Per Day. 
Grains or 
Minims. 
Grammes 
or c.c. 
Grains or 
Minims. 
Grammes 
or c.c. 
Powdered leaves 
Infusion . 
Tincture . 
Digitalin . 
Extract . . 
44 gms. 
480 m. 
45 m. 
•03 gm. 
3-0 „ 
•3 grm. 
28-3 c.c. 
3 c.c. 
•002 grm. 
•2 „ 
15-4 grns. 
1440 m. 
135 m. 
•09 grn. 
12-0 „ 
1-0 grm. 
84-9 c.c. 
9 c.c. 
•006 grm. 
•3 ' „ 
§ 552. Statistics. —The main knowledge which we possess of the 
action of digitalis is derived from experiments on animals, and from 
occasional accidents in the taking of medicines ; but in comparison with 
certain toxic agents more commonly known, the number of cases of 
death from digitalis is very insignificant. Of 42 cases of digitalis¬ 
poisoning collected by Husemann, 1 was criminal (murder) ; 1 the 
result of mistaking the leaves for those of borage ; 42 were caused in 
medicinal use—in 33 of these last too large a dose had been given, in 3 
the drug was used as a domestic remedy, in 2 of the cases the prescrip¬ 
tion was wrongly read, and in 1 digitalis was used as a secret remedy. 
Twenty-two per cent, of the 45 were fatal. 
§ 553. Effects on Man. —It was first distinctly pointed out by Tar- 
dieu that toxic doses of digitalis, or its active principles, produced not 
only symptoms referable to an action on the heart, but also, in no small 
degree, gastric and intestinal irritation, similar to that produced by 
arsenic. Tardieu also attempted to distinguish the symptoms produced 
by the pharmaceutical preparations of digitalis (the tincture, extract, 
etc.), and the glucoside digitalin ; but there does not appear a sufficient 
basis for this distinction. The symptoms vary in a considerable degree 
in different persons, and are more or less tardy or rapid in their develop¬ 
ment, according to the dose. Moderate doses continued for some time 
