24 
Digitalis  Therapy. 
f  Am.  Jour.  Pharm. 
*•     January,  1918. 
DIGITALIS  THERAPY  AND  THE  PRESENT  SHORTAGE 
IN  DRUGS.1 
By  Robert  A.  Hatcher,  M.D., 
Professor  of  Pharmacology  and  Materia  Medica,  Cornell  University 
Medical  College,  New  York. 
The  following  brief  review  of  the  present  status  of  the  materia 
medica  of  the  digitalis  group  and  its  relation  to  therapeutics  has 
been  prepared  at  the  request  of  Prof.  Julius  Stieglitz,  chairman  of 
a  committee  on  synthetic  drugs,  appointed  by  the  National  Research 
Council,  because  of  the  present  want  of  many  preparations  of  this 
group  that  have  come  into  more  or  less  widespread  use. 
All  of  the  members  of  this  group,  including  many  crude  drugs  and 
their  galenic  preparations,  as  well  as  glucosidal  active  principles,  ex- 
ert a  qualitatively  similar  therapeutic  action  on  the  heart  when  they 
are  brought  into  the  blood  stream ;  but  the  various  members  of  the 
group  vary  enormously  in  their  activity  and  in  the  rate  of  their  ab- 
sorption from  the  alimentary  tract. 
These  differences  in  behavior  of  the  different  members  of  the 
group  have  resulted  in  the  development  of  faith  in  one  or  the  other 
of  the  numerous  preparations  and  specialties,  and  a  corresponding 
distrust  of  all  others  on  the  part  of  those  physicians  who  have  not 
appreciated  the  importance  of  dosage  and  the  several  methods  of 
administration  best  suited  to  the  individual  preparation  in  securing 
the  results  aimed  at.  Those  who  are  thus  left  without  the  prepara- 
tion to  which  they  are  accustomed  feel  the  want  keenly,  and  the 
present  discussion  is  designed  to  point  the  way  to  relief  from  these 
conditions. 
Digitalis,  digitoxin,  strophanthus,  strophanthin  and  ouabain 
exert  the  same  kind  of  action  on  the  heart  directly,  and  on  the  cir- 
action  indirectly,  as  previously  stated  in  different  words ;  but  the 
action  of  digitalis  and  its  most  active  principle,  digitoxin,  is  far  more 
lasting  than  that  of  the  others.  It  is  necessary  to  caution  the  reader 
against  confusing  "  actions  "  and  "  effects  "  in  this  connection. 
When  an  attack  of  acute  cardiac  dilatation  is  relieved  by  any 
member  of  the  group  whatever,  the  effect  is  permanent,  provided 
the  cause  of  the  failure  is  not  continuously  active;  but  in  various 
1  Reprinted  from  the  Journal  of  the  American  Medical  Association. 
