DIGITALIS GROUP. 
447 
§ 553 -] 
Two of his comrades had also been to the “ Freimacher ,” and had 
suffered from the same symptoms, but they had left off the use of the 
medicine before any very serious effect was produced. 1, 2 
An instructive case of poisoning by digitoxin occurred in the person 
of Dr Koppe, in the course of some experiments on the drug. He had 
taken 1-5 mgrm. in alcohol without result; on the following day (May 14) 
he took 1 mgrm. at 9 a.m., but again without appreciable symptoms. 
Four days later he took 2 mgrms. in alcoholic solution, and an hour 
afterwards felt faint and ill, with a feeling of giddiness ; the pulse was 
irregular, of normal frequency, 80 to 84. About three hours after 
taking the digitoxin, Dr Koppe attempted to take a walk, but the 
nausea, accompanied with a feeling of weakness, became so intense that 
he was obliged to return to the house. Five hours after the dose, his 
pulse was 58, intermittent after about every 30 to 50 beats. Vomiting 
set in, the matters he threw up were of a dark green colour ; after 
vomiting he felt better for a quarter of an hour, then he again vomited 
much bilious matter ; the pulse sank to 40, and was very intermittent, 
stopping after every 2 or 3 beats. Every time there was an intermission, 
he felt a feeling of constriction and uneasiness in the chest. Six and a 
quarter hours after the dose there was again violent vomiting and 
retching, with paleness of the face. The muscular weakness was so 
great that he could not go to bed without assistance. He had a disorder 
of vision, so that the traits of persons well known to him were changed, 
and objects had a yellow tint. He had a sleepless night, the nausea 
and vomiting continuing. During the following day the symptoms 
were very similar, and the pulse intermittent, 54 per minute. He 
passed another restless night, his short sleep being disturbed by terrible 
dreams. On the third day he was somewhat better, the pulse was 60, 
but irregular and still intermittent; the nausea was also a little abated. 
The night was similar in its disturbed sleep to the preceding. He did 
not regain his full health for several days. 3 
A third case may be quoted, which differs very markedly from the 
preceding, and shows what a protean aspect digitalin poisoning may 
assume. A woman, twenty-three years old, took on June 26, at 7 a.m., 
1 Kohnhorn, Vierteljhrsschr. f. ger. Med., 1876, n. F. xxiv. 402. 
2 There is an interesting case on record, in which a woman died from the ex¬ 
pressed juice of digitalis. She was twenty-seven years of age, and took a large un¬ 
known quantity of the freshly expressed juice for the purpose of relieving a swell¬ 
ing of the limbs. The symptoms came on almost immediately : she was very sick, 
and was attacked by a menorrhagia. These symptoms continued for several days 
with increasing severity, but it was not until the fifth day that she obtained medical 
assistance. She was then found semi-comatose, the face pale, pulse slow, epigastrium 
painful on pressure, diarrhrea and hiccough were frequent. She died on the twelfth 
day. The post-mortem appearances showed nothing referable to digitalis save a few 
spots of inflammation on the stomach.—Causse, Bull, de Therapeutique, lvi. 100 ; 
Brit, and For. Med. Chir. Review, xxvi. 523, 1860. 
3 Arch. f. exp. Path. u. Pharm., iii. 289, 1875. 
