2  0 
D  ig  it  a  lis  TJi  crapy . 
|  Am.  Jour.  Pharm. 
*-     January,  19 18. 
talis  exerts  its  action  in  much  less  time  than  was  formerly  believed 
to  be  possible. 
The  action  of  an  intravenous  dose  of  strophanthin  or  ouabain 
is  not  so  lasting  as  is  that  of  a  corresponding  dose  of  digipuratum, 
but  it  lasts  until  it  can  be  supplemented  by  the  oral  administration 
of  digitalis. 
Another  fallacy  that  dies  hard  is  that  digitalis  and  digitoxin  act 
on  the  vessels  and  cause  high  blood  pressure,  and  that  they  are 
therefore  contraindicated  in  cases  in  which  the  blood  pressure  is 
already  high.  This  has  been  the  greatest  stumbling  block  in  the  way 
of  the  use  of  digitalis,  next  to  that  of  regulation  of  dosage.  Every 
one  of  the  digitalis  bodies  acts  on  the  vessels  when  enormous  doses 
are  passed  directly  into  them,  but  this  action  is  never  induced  by 
therapeutic  doses.  The  contrary  belief  rests  on  the  observation  of 
the  effects  of  massive  doses  in  animal  experimentation,  and  is  not 
supported  by  any  careful  clinical  observations  or  experiments  with 
therapeutic  doses. 
Among  the  less  important  fallacies  that  have  severally  contributed 
to  the  distrust  of  digitalis  and  have  been  utilized  by  manufacturers 
to  their  own  advantage,  the  following  may  be  mentioned  briefly :  All 
drugs,  preparations  and  active  principles  of  this  group  without  ex- 
ception cause  nausea  and  vomiting  in  overdoses  through  their  action 
on  the  vomiting  center  in  the  medulla — not  through  any  direct  action 
on  the  stomach ;  hence  it  cannot  be  avoided  by  any  mere  change  in 
the  mode  of  administration,  or  mere  choice  of  preparation,  but  only 
by  proper  regulation  of  the  dosage — and  by  dosage  I  mean  the 
amount  which  actually  enters  the  blood  stream  and  which  alone  can 
act  on  the  heart. 
None  of  the  drugs  of  this*  group  are  actively  diuretic  through 
any  direct  action  on  the  kidneys.  They  induce  diuresis  solely 
through  an  improved  circulation.  That  does  not  mean  either  a 
higher  or  a  lower  blood  pressure  in  every  case ;  it  means  a  more  ef- 
fective circulation,  one  better  adapted  to  the  needs  of  the  individual 
patient.  This  sometimes  means  an  increase,  sometimes  a  decrease, 
in  pressure. 
All  digitalis  galenicals,  tincture,  infusion,  extract  and  fluidex- 
tract,  exert  the  same  kind  of  action,  because  they  all  contain  all  of 
the  active  principles  of  the  drug. 
All  digitalis  bodies  without  exception  have  the  disadvantage  of 
being  absorbed  somewhat  slowly  and  irregularly  from  the  alimentary 
