212 
Remarks  on  Digitalis. 
Am.  Jour.  Pharm. 
May,  1915. 
the  second  one  not  often  used.  According  to  all  authorities,  the 
tincture  and  infusion  are  the  two  most  reliable  preparations,  but 
there  is  a  vast  difference  of  opinion  as  to  the  relative  value  of  the 
two.    Herzfeld  states  that: 
"  I  believe  that  in  this  country  the  tincture  is  the  least  reliable 
of  all  preparations  of  digitalis,  particularly  since,  for  the  sake  of 
convenience,  it  is  frequently  prepared  by  diluting  the  fluidextract, 
which  in  itself  may  be  inferior." 
Other  authorities  also  dwell  on  the  improper  preparation  of 
tinctures  from  fluidextracts.  It  is  well  worth  while  to  stop  a  minute 
to  investigate  this  charge.  I  myself  have  in  former  years,  when 
physicians  made  this  remark,  asked  them  how  many  pharmacists,  to 
their  positive  knowledge,  made  their  tinctures  from  fluidextracts. 
Generally  the  answer  was:  "  Well,  of  course,  I  do  not  know,  but 
conclude,  from  the  fact  that  sometimes  tinctures  do  not  produce 
the  desired  effect,  that  they  are  made  improperly."  And  when  I 
replied :  "  Doctor,  are  you  sure  that  in  such  cases  you  always 
ordered  the  right  medicine?"  the  answer  would  be:  "Of  course 
I  did;  I  diagnosed  the  case  myself."  In  other  words,  whenever  the 
patient  does  not  respond  to  the  treatment  the  fault  lies  with  the 
pharmacist,  but  not  with  the  physician.  The  unbiased  observer  will 
say,  if  men  are  apt  to  make  mistakes  there  will  be  as  many  mistakes 
made  by  physicians  in  diagnosing  as  by  pharmacists  in  dispensing. 
I  personally  do  not  believe  that  the  practice  of  making  tincture  from 
fluidextract  is  general ;  it  may  prevail  among  lazy  and  indifferent 
druggists,  who  hardly  have  any  prescription  trade  for  this  very 
reason. 
Coming  back  to  our  subject,  there  is  besides  Doctor  Herzfeld  no 
other  authority  to  reject  the  tincture.  As  a  rule,  the  tincture  is 
preferred  to  the  infusion,  so  far  as  reliability  is  concerned,  and 
whenever  the  full  cardiac  effect  of  digitalis  is  required.  As  a 
diuretic,  in  cases  of  faulty  circulation  of  blood  through  the  kidneys, 
the  infusion  is  preferred  by  probably  95  per  cent,  of  all  practitioners. 
An  exception  is  Doctor  R.  A.  Hatcher,  who  in  a  recent  paper  states 
that : 
"  As  a  matter  of  fact,  a  properly-made  infusion,  as  well  as  the 
tincture,  contains  all  of  the  therapeutic  active  principles  of  digitalis." 
He  tries  to  prove  this  statement  by  saying  that  the  marc  left 
after  making  the  tincture  is  inert,  and  if  an  infusion  be  made  with 
this  marc  and  tested  on  a  frog,  the  truth  of  this  statement  becomes 
