70  Standardisation  of  Heart  Tonics.  {A?eb™?S,Pi»i™' 
Work  of  the  Normal  Heart. 
Few  realize  the  vast  amount  of  work  performed  each  day  by  the 
heart  of  the  normal  adult.   One-fifth  the  total  muscular  energy  of  the 
body  is  used  in  propelling  the  heart  and  about  twelve  tons  of  blood 
are  pumped  each  day. 
New  Methods  of  Observing  Conditions  of  the  Heart. 
The  electro-cardiographic  method  31  has  made  possible  not  only 
the  accurate  diagnosis  of  diseases  of  the  heart  but  also  enables  the 
physician  to  observe  the  effects  of  the  medicine  he  has  prescribed. 
The  practice  of  medicine  under  these  conditions  has  become  scientific, 
not  empiric,  and  if  uniform  preparations  of  the  "  heart  tonics  "  can 
be  supplied,  the  physician  needs  only  to  consider  the  idiosyncrasy  of 
the  patient. 
Summary. 
In  presenting  this  subject  I  have  attempted  to  dwell  not  alone  on 
the  methods  used  in  standardizing  the  "  heart  tonics  "  but  the  various 
factors  that  must  be  considered  in  producing  reliable  and  potent  prep- 
arations. The  clinical  side  of  the  problem  must  not  be  lost  sight  of, 
and  when  a  preparation  is  made  that  will  produce  certain  therapeutic 
results  it  is  of  vital  importance  to  produce  another  lot  having  the 
same  action.  Uniformity  is  practically  as  important  as  potency. 
When  a  competent  observer  like  Faught 32  says  "  Usual  preparations 
are  variable  and  cannot  be  depended  upon  unless  coming  from  a 
reliable  source.  I  have  seen  less  effect  follow  the  administration 
of  20  minims  of  a  poor  preparation  than  5  minims  of  a  good  active 
one  "  it  is  time  to  improve  conditions.  Conditions  can  be  improved 
by  the  adoption  of  pharmacological  standards  and  methods  for  these 
drugs.  At  the  present  time  the  manufacturers  who  have  wisely 
adopted  physiological  standardization  of  their  products  often  have 
different  standards  while  those  that  have  not  adopted  physiological 
standards  have  no  assurity  that  these  important  drugs  are  even  active. 
-  BIBLIOGRAPHY. 
1  Withering,  "  An  Account  of  the  Foxglove  and  Some  of  its  Medicinal  Uses." 
2  Mackenzie,  "  Digitalis  "  Heart,  volume  2,  No.  4,  page  279. 
3  Mackenzie,  "  A  Scheme  for  Investigating  the  Treatment  on  the  Human 
Heart "  Heart,  volume  2,  page  9. 
*  Berkeley,  Merck's  Archives,  September,  1910,  page  275. 
5  Proceedings  of  American  Pharmaceutical  Association,  1902,  page  415. 
6  Cushny,  "  Pharmacology  and  Therapeutics." 
