AmjJu^i9Pos.arm'}     Notes  on  "Physiological  Testing-:'  329 
standardizing.  Naunyn1  made  the  assertion  that  he  would  not  care 
to  be  a  physician  without  digitalis.  Focke,2  Edmunds,  Kobert, 
Fraenkel,  Bennefeld  and  others  have  recently  called  attention  to 
the  marked  variation  in  strength  of  digitalis  leaves.  In  fact,  Ott 
says  that  the  leaves  of  digitalis  grown  in  Bohemia  are  too  toxic  for 
clinical  use.  Unfortunately  the  appearance  of  the  leaves  does  not 
give  any  indication  as  to  their  activity. 
Dixon3  says:  "  For  my  part  I  unhesitatingly  express  the  belief 
that  many  hundreds  of  patients  die  annually  from  digitalis  and  allies 
not  possessing  the  virtues  which  are  required  of  them."  The  clini- 
cal testing  of  such  preparations  on  man  may  not  always  yield  satis- 
factory ideas  as  to  their  real  activity,  as  Loewy4  has  shown  that 
many  of  these  preparations  are  injured  by  the  normal  acidity  of  the 
stomach.  Focke5  showed  by  physiological  tests  that  the  leaves 
lost  much  of  their  activity  by  ordinary  keeping.  He  believes  that 
light  has  little  to  do  with  this  deterioration,  and  that  it  is  a  question  of 
carefully  drying  the  leaves  and  then  keeping  them  in  air-tight  vessels 
protected  from  moisture.  Thus  Wang,  who  tested  leaves  kept  in 
such  a  manner  for  two  years,  found  they  had  the  same  toxic  value 
for  frogs  as  fresh  leaves,  while  Focke  kept  such  leaves  unchanged 
for  three  years.  Wolff6  found  that  it  was  desirable  to  dry  the  leaves 
in  vacuo  at  a  definite  temperature,  as  the  ordinary  drying  in  air 
might  be  injurious  to  their  activity. 
1  Muench.  med.  Woch.,  1904,  p.  14x3. 
2  Focke,  C.  Ueber  d.  jahreszeitl.  Schwankungen  in  d.  Starke  d.  officinell. 
Folia  Digitalis,  Ther.  d.  Gegenw.  n.  s.,  Vol.  4,  p.  44.  1902.  Ott.  Verhandl.  d. 
Kongresses  f.  Innere  Med.,  1901,  p.  S9.  Fraenkel,  A.  Ueber  d.  physiol. 
Dosirung  von  Digitalispraparaten.  1  her.  d.  Gegenw.  n.  s.,  Vol.  4,  p.  112,  1902. 
Fraenkel,  A.  Bxper.  Untersuch  ii.  d.  Wirksatnkeit  d.  verschied.  Digitalis- 
praparaten." Charite  Annulen,  Vol.  6,  p.  207.  18S1.  Fdmunds,  C.  W.  Stand- 
ardization of  Cardiac  Remedies.  Jour.  Amer.  Med.  Assoc.,  Vol.  48,  p.  1744. 
1907.  Benuefeld,  F.  Ueber  Digitalistincturen.  Dissert.  Gottingen,  1881. 
L/utzkaja,  S.  Ueber  d.  Wirkungswert  d.  Folia  Digitalis.  Arch.  Internat.  de 
Pharmakodynamie,  Vol.  18,  p.  77.  190S. 
3  Dixon,  W.  E.    Drug  Fallacies.    Brit.  Med.  /our.,  Vol.  2,  Nov.  1906. 
*  Loewy,  J.  Ueber  d.  Bedeutung  d.  Reaktion  d.  Digitalisinfuses  f.  seine 
Wirksamkeit.    Wien.  klin.  Woch.,  Vol.  19,  p.  1157.  1906. 
5  Focke,  C.  Physiol.  Wertbestimmung  d.  Digitalisblatter.  Arch.  d.  Pharm., 
Vol.  241,  p.  140.  1903. 
6  Wolff,  A.  Ueber  d.  Physiol.  Dosirung  von  Digitalispraparaten.  Ther.  d. 
Gegenw.  n.  s.,  Vol.  4,  p.  423.  1902. 
