SPHERE OF ACTION
Through the cerebro-spinal system, Digitalis acts especially upon the muscular tissue of the heart and arteries, paralyzing their action to a great degree. Hughes says, We conclude that Digitalis acts directly upon the muscular tissue of the heart, which it weakens even to the extent of paralysis; that the increase of the pulse, which results from small doses, depends mainly upon cardiac debility, Nature endeavoring to make up by greater frequency for decreasing power; and that the retardation of the heart’s action, which is caused by large doses is due to an influence transmitted through the vagi. The irregularity and intermission of the pulse so characteristic of the drug, we also ascribe to the cardiac debility it induces. The researches of M.
Claude Bernard show that Digitalis is one of the poisons which act directly upon the muscular tissue, paralyzing and killing it.
It affects that portion of muscular tissue which constitutes the heart earlier than any other, so that in cold-blooded animals (as frogs) the heart’s action may cease for four hours before general death ensues, producing a dead heart in a living body. Rigor mortis sets in exceedingly early, and on opening the thorax immediately after death, the heart is found contracted, rigid, motionless, and totally empty. A farther examination discloses remarkable chemical and electrical changes in the heart and other muscles. The muscular juice is acid instead of alkaline, and the external surface is electrically negative to the cut surface, instead of, (as normally) positive. The immediate cause of this phenomenon has been shown to be the change of the muscular juice from alkaline to acid, and this very change is involved in the destructive action of the drug upon the integrity of the muscular tissue.
It also has a specific action upon the functions of the vagi. The descending colon, kidneys and brain are also more or less affected.
In all the diseases in which Digitalis will be found useful, the heart will be more or less involved, accompanied with irregular or intermittent pulse, excited by the least movement.
The least movement produces violent palpitation of the heart.
A sensation as if the heart would stop beating if she moved, with fear of impending death.-HALE.
Frequent stitches in the heart.
Dropsy in organic disease of the heart, and in anasarca following scarlatina.- MARCY and HUNT.
Lungs.-For coughs, with profuse, loose purulent expectoration, it is one of the most useful remedies in the materia medica; given in the Digita-line.
Asthma, with much rattling mucus in the lungs; rapid respiration.
Digestive Organs.-Profuse flow of frothy saliva. Stinging in the throat between the acts of deglutition.
Nausea as if she would die; more in the morning.
Motion produces vomiting and great faintness.
Smell of food excites violent nausea, with clean tongue, thirst for water, and absence of fever.
Tendency to nausea without real nausea.-RAUF.
Feeling of goneness in the stomach, as if he would die, with deathly nausea and vomiting.
Ash colored stools. This color of the stools is probably caused by a depraved secretion of the follicles of the colon, and not from hepatic disease.
Stools in the evening passing great quantities of ascarides.
Obstinate constipation for several weeks.
Frequent and painful emission of small quantities of burning urine of a dark cloudy color.
Profuse and frequent emission of clear pale urine.
Sexual Organs of Men.-No drug diminishes and arrests nocturnal emissions with as much promptitude as Digitaline; dose one grain every morning, or every third morning; should not be given in the evening, or it may disturb the sleep.-BAEHR. I can testify to the great utility of Digitaline in spermatorrhoea.
Head.-Desponding and fearful, with great apprehension of the future.
Excessive desire to be alone.
Hissing before the ears.
Bloating and paleness of the face.
Objects seem paler than they really are, and have a greenish look.
Generalities.-Debility, with tendency to faint and perspire.
Jaundice, in bilious diseases.
Cold feet and hands.
Sudden flushes of heat, followed by great debility, at the change of life, with irregularity of the pulse; the least motion, even raising the arms, brings on palpitation.
Diseases that call for Digitalis have some part of the functions of the vagi more or less disturbed.