5 1 8  Digitalis  and  Its  Preparations.        \  kfJ^J\^ 
In  a  paper  entitled  "  Digitalis  and  Its  Preparations,"  and  which 
might  well  be  called  "  The  Truth  About  Digitalis,"  Dr.  Robert  A. 
Hatcher,  professor  of  pharmacology  at  Cornell  University,  explodes 
some  conceptions  of  this  drug. 
Digitalis,  Dr.  Hatcher  states,  acquired  a  reputation  as  a  house- 
hold remedy  in  dropsy  some  time  before  jt  was  introduced  into 
medical  literature.  One  of  the  earliest  of  writers  about  this  drug 
was  Dr.  Withering,  an  English  physician.  This  physician  stated  that 
the  wild-grown  drug  was  more  active  than  the  cultivated.  This 
belief,  Dr.  Hatcher  says,  continues  to  be  still  accepted.  It  is  also 
believed  that  only  the  leaves  of  the  second  year's  growth  collected 
at  the  time  of  flowering  should  be  used.  This  claim  is  supported  by 
most  of  the  pharmacopoeias  of  the  world.  How  this  belief  originated 
no  one  knows,  but  it  surely  was  the  result  of  superficial  observations, 
as  Worth  Hale  and  other  pharmacologists  have  found,  through 
experiments  on  animals,  that  leaves  of  the  first  year  are  more  active 
than  the  average  leaf  of  the  second  year.  And  it  is  very  interesting 
to  know  that  the  leaves  used  in  this  work  were  from  cultivated  plants. 
"  Another  curious  misconception  regarding  digitalis  which  is 
hard  to  explain  is  that  the  leaf  grown  in  certain  regions  is  more 
active  than  that  grown  in  other  localities.  It  has  often  been  stated 
that  the  Bohemian  leaf  is  too  toxic  for  therapeutic  use.  Leaves 
grown  in  a  single  locality  often  show  great  variations  in  activity, 
and  it  is  true  that  Bohemian  digitalis  is  often  very  potent.  The 
toxic  action  of  digitalis  is  simply  an  extension  of  the  therapeutic 
action,  and  it  would  be  as  logical  to  complain  of  the  toxicity  of 
aconite  or  mix  vomica  as  of  that  of  digitalis. 
4<  At  the  other  extreme  is  the  view  that  activity  and  quality  must 
necessarily  run  parallel.  Other  things  being  equal,  a  drug  of  a  given 
degree  of  activity  is  preferable  to  one  showing  but  half  of  the  activ- 
ity ;  but  the  case  with  digitalis  is  not  quite  so  simple,  and  it  is  far  more 
important  to  have  a  drug  of  uniform  activity  than  to  have  the  most 
active  drug  that  can  be  obtained.  Furthermore,  even  a  uniformly 
potent  digitalis  is  not  necessarily  better  than  a  uniform  one  of  less 
potency,  for  digitalis  contains  (or  yields)  several  therapeutic  prin- 
ciples, and  at  least  one  substance,  saponin,  which  is  of  minor  toxico- 
logical  importance  ; — of  minor  importance  because  it  is  present  in  the 
leaf  only  in  traces.  While  all  of  the  therapeutic  principles  of  digitalis 
exert  a  more  or  less  qualitatively  similar  action  on  the  heart,  they 
differ  in  certain  essential  side  actions,  and  it  does  not  necessarily 
