AFebraairy  ^iuET' }     Standardization  of  Heart  Tonics.  63 
that  these  favorable  results  may  be  attributed  to  some  other  reason 
than  its  effect  on  the  heart,  per  se. 
It  is  needless  to  say  that  Digitalis  has  been  given  thousands  of 
times  when  its  use  was  not  indicated  and  doubtless  its  failure  to  pro- 
duce favorable  results  under  improper  conditions  has  been  responsible, 
more  than  once,  for  condemnation  of  the  particular  preparation  of 
digitalis  being  used.4  It  has  been  repeatedly  stated  that  analogous 
preparations  of  digitalis  made  by  various  manufacturers  differ  mark- 
edly in  strength,  that  digitalis  preparations  rapidly  deteriorate  and 
that  only  the  leaves  of  the  first  year's  plant  are  active.  It  is  no  doubt 
true  that  analogous  digitalis  preparations  differ  markedly  in  strength,7 
but  it  is  very  doubtful  if  the  usual  galenical  preparations  deteriorate 
rapidly,8  or  that  only  the  leaves  of  the  first  year's  plant  are  active.9 
It  is  possible,  but  not  at  all  probable,  that  only  the  digitalis  plants 
which  are  in  flower  are  physiologically  active  and  this  need  not  ex- 
clude the  first  year's  plants  as  John  A.  Bornemann  10  has  shown  me 
a  digitalis  plant  with  plenty  of  flowers  on  it,  although  it  was  a  plant 
of  the  first  year's  growth.  Certain  it  is  that  the  therapeutic  action 
of  digitalis  as  stated  by  various  authors  is  sadly  confusing  and  no 
doubt  much  of  this  confusion  is  due  not  alone  to  clinical  reports  where 
digitalis  was  not  indicated,  but  to  the  pharmacologic  variability  of  the 
preparations  themselves. 
Chemistry  of  Digitalis. 
Almost  every  pharmaceutical  chemist  of  note  has  tried  to  isolate, 
unchanged,  the  complex  active  principles  that  are  present  in  digitalis. 
The  great  Schmiedeberg  and  Kiliani  agreed  that  the  four  glucosides 
which  they  separated  and  called  digitoxin,  digitalin,  digitalein  and 
digitophyllin,  possess  a  true  digitalis  action.  They  separated,  in  addi- 
tion, other  glucosides  such  as  digitonin,  digitin  and  digitoflavin,  but 
they  considered  these  decomposition  products.  Several  carbohy- 
drates which  came  from  the  decomposition  of  the  glucosides,  were 
also  described. 
When  one  looks  up  the  vast  literature  on  the  chemistry  of  digitalis 
it  is  quite  evident  that  different  glucosides  are  sometimes  given  the 
same  name  by  different  authors  and  vice  versa. 
Recently  Kraft 11  has  contributed  an  admirable  article  on  this 
subject  and  his  work  is  now  generally  accepted.  He  claims  that  both 
Schmiedeberg  and  Kiliani  worked  with  German  digatalin,  a  commer- 
cial product  made  largely  from  digitalis  seeds,  hence  their  results  are 
