t 
334  Tincture  of  Fat-Free  Digitalis.  {AmjJiy'iSarm- 
Dr.  Daniel  E.  Hughes,  Chief  Resident  Physician  of  the  Philadel- 
phia Hospital,  has  kindly  furnished  me  with  the  following  clinical 
statement : 
"  For  the  past  five  years  we  have  been  using  in  the  wards  of  the 
Philadelphia  Hospital  the  tincture  of  fat-free  digitalis  made  by 
Joseph  W.  England,  the  Chief  Druggist  of  the  hospital,  to  replace 
the  official  tincture.  The  vast  majority  of  the  cardiac  and  nephritic 
patients  coming  to  the  Philadelphia  Hospital, have  had,  as  a  marked 
and  stubborn  complication,  chronic  gastric  catarrh,  and  could  not 
stand  the  administration  of  the  official  digitalis  tincture,  but  could 
take  our  more  bulky  infusion.  To  secure  the  desired  cardiac  and 
nephritic  action  of  this  valuable  drug  required  large  doses  of  the 
infusion,  which  was  a  very  serious  drawback  to  its  use. 
"  Mr.  England's  attention  was  called  to  the  subject,  and  he  sug- 
gested that  he  might  be  able  to  prepare  a  tincture  of  digitalis  of  the 
same  strength  as  the  official  preparation,  but  devoid  of  the  nauseat- 
ing proximate  principles  of  the  latter.  He  prepared  his  prepara- 
tion and  we  submitted  it  to  extended  employment.  After  the  con- 
tinued use  of  this  particular  preparation  of  digitalis,  I  can  speak  of 
its  efficiency  and  non-nauseating  properties.  I  am  confident  that  it 
is  much  more  promptly  absorbed  than  the  official  tincture,  and  this 
makes  the  cumulative  action  of  this  drug  almost,  if  not  altogether, 
nil,  Again,  its  more  prompt  absorption  is  shown  by  its  quicker 
action  upon  the  heart  and  increase  in  the  flow  of  the  urine. 
"  The  non-irritating  properties  of  this  special  tincture  of  digitalis 
are  forcibly  shown  upon  its  hypodermic  use,  abscesses  having  never 
followed  its  use,  while  the  official  tincture  almost  invariably  causes 
pain,  swelling  and  abscess-formation  on  hypodermic  use." 
This  fat-free  tincture  of  digitalis  was  made  by  exhausting  the  leaves, 
while  freshly  ground  (to  a  No.  60  powder),  with  purified  petroleum 
benzin,  either  by  maceration  with  solvent  in  excess  for  forty- eight 
hours,  if  in  small  quantity,  or  by  maceration  and  subsequent  perco- 
lation, if  in  larger  quantity,  repeating  the  solvent  treatment  until 
all  the  fat,  etc.,  is  removed.  The  residue  is  then  dried  by  exposure 
to  air,  taking  care  that  no  traces  of  benzin  odor  remain.  While 
benzin  is  very  volatile,  the  last  portions  of  it  volatilize  rather 
slowly,  relatively,  when  spontaneously  evaporated,  especially  if 
adherent  to  vegetable  structure.  Exposure  of  the  residue  to  the 
sunlight,  as  well  as  to  open  air,  yields  the  best  results. 
