Synonym – Digitalis Purpurea. Natural order – Scrophulariaceae. Common name – Fox Glove. Habitat – A beautiful plant, common through Europe, cultivated in United States. Preparation – Tincture form the fresh leaves of the uncultivated plant in its second season.
GENERAL ANALYSIS
Digitalis acts profoundly upon the muscular substance of the heart and arteries through the pneumogastric and the vaso-motor nerves, producing debility of these tissues even to paralysis, causing greatly increased arterial tension and a slow and intermittent pulse. “Its action upon the heart is remarkable in that it produces vigorous systolic contractions, which become very irregular, one portion of the ventricle dilating while another remains in a state of contraction; finally, the heart stops in systole.” – (T. F. Allen.) It also secondarily produces functional derangements of the brain, the kidneys, and the digestive apparatus. The chief characteristic of Digitalis is its extremely slow, intermittent pulse.
CHARACTERISTIC SYMPTOMS
Mind. Great anxiety (Aconite, Arsenicum, Rhus tox.); about 6 P.M., with dread of the future. Apprehensive; sad with great depression; extremely aggravated by music (Sabin.) Thinking difficult, and weakness of memory (Anacardium, Kreosotum, Lachesis, Nux moschata, Natr. mur., Phosphorus ac.).
Head Confusion and heaviness of the head. Vertigo; with anxiety and faintness (Aconite), on rising from sitting (Bryonia, Sulphur), with very slow pulse. Head constantly falls backwards while sitting and walking, as form paralysis of cervical muscles (Agaricus). Sudden cracking noise in the head during siesta, with starting, as in a fright. Head heavy, confused, as if full. Throbbing headache in the forehead (Belladonna, Cinchona).
Eyes. Pupils dilated and insensible (Belladonna, Cicuta, Hyoscyamus, Opium, Stramonium).
Ears. Hissing in both ears, as from boiling water.
Face Face pale; sickly, death-like expression (Arsenicum).
Stomach Extreme thirst (Aconite, Bryonia). Deathly nausea (Ant. tart., Ipecac., Lobelia); vomiting with irregular feeble pulse. Faintness or sinking at the stomach; feels as if he were dying (Tabac.). Extreme anxiety in the epigastrium, causing frequent deep sighs. Extreme sensitiveness in epigastrium (Belladonna, Bryonia, Lycopodium).
Stool Constipation. Ash-colored diarrhoea; nearly white.
Urinary Organs. Constant urging to urinate, with scanty discharge (Arsenicum, Apis, Coloc.). Frequent urination at night (Ambra., Borax., Coni., Phosphorus ac., Sepia). Dragging in bladder as if distended, not relieved by frequent micturition. After micturition pressure in bladder and burning in urethra. Functions of kidneys suspended. Urine scanty, dark, turbid (Cantharis, Chelidonium, Cina); depositing a red sediment.
Male Organs. Copious nocturnal emissions (Aurum).
Respiratory Organs. Frequent painless hoarseness. Respiration irregular (China, Gelsemium), difficult; slow, deep, performed by frequent deep sighs. Feeble respiratory murmur. Suffocative painful constriction of the chest, as if internal parts were grown together. Dry spasmodic cough. OEdema of the lungs. Expectoration of blood, or streaked with blood (Phosphorus). Constant desire to take a deep breath, which seems prevented by some impediment in the chest, with dry cough, especially on deep inspiration.
Heart and Pulse. Uneasiness in region of heart (Physos.), with sensation of weakness in forearm. Sudden sensation as though the heart stood still, with great anxiety. Heart’s action feeble (Lycopodium); beats more frequent and intermittent (Coni., Natr. mur., Kali carb.); sometimes irregular. Thready (Aconite), slow, intermittent pulse (Natr. mur.); irregular; small. Pulse weak and jerky, on slowly sitting up after reclining in a chair. Extremely slow pulse (Ascl. c., Can. ind., Opium, Fever.).
Lower Limbs. Infiltration of lower extremities (Arsenicum). Lassitude in legs and knees.
Generalities. Great weakness and sinking of strength; mornings (Arsenicum, Bryonia, Phosphorus), on waking; sudden with sweat. Cold, pale and covered with profuse sweat (Tabac.). Could not bear the upright position. Convulsions. Faintness; feeling of great debility.
Sleep Uneasy, unrefreshing sleep. Frequent waking, as form anxiety.
Fever. Great coldness of the skin. Coldness of the extremities. Cold, clammy, copious perspiration (Arsenicum, Camph.).
Compare Antim crud., Apocy., Arsenicum, Belladonna, Bryonia, Calcarea, Coni., Ferrum, Helleborus, Kalm., Lobelia, Lycopodium, Nux v., Opium, Pulsatilla, Sepia, Spigelia, Sulphur, Tabac., Zincum met.
Antidote. Camph., Nux v., Opium To large doses: Sweet milk with Foenum graecum; vegetable acids, vinegar, infusion of galls, ether, camphor.
Digitalis Antidotes. Wine.
THERAPEUTICS.
The chief use of Digitalis is in the treatment of organic disease of the heart. With the old school it is used, indiscriminately, in large doses as a “cardiac sedative.” Given in this manner it will often afford prompt temporary relief, but the ultimate results are disastrous, the drug soon producing its characteristic physiological effects, weakness of the heart muscles, dilatation, etc., and thus hastening a fatal termination. Digitalis should only be employed in small doses, and only when its symptoms correspond to those of the individual case. These symptoms have already been detailed, the most important being a great anxiety and oppression, dyspnoea, sudden sensation as if the heart stood still, pulse feeble, irregular, fluttering, intermittent, or extremely slow; any motion, especially rising from a bed or chair, causes the pulse to become rapid, weak and jerky, sometimes cyanosis and even syncope. With this class of symptoms Digitalis may be indicated in any form of cardiac disease, but it is especially useful in pericarditis with effusion, and in all forms of dropsy useful in pericarditis with effusion, and in all forms of dropsy of cardiac origin; hydrothorax; emphysema, etc. Aneurism. Cyanosis. Digitalis is frequently indicated in inflammatory diseases of the kidneys, especially when the urine is suppressed, and there is pulmonary oedema, and threatened heart failure. Nephritis, especially after scarlet fever-post-scarletinal dropsy; also useful in cystitis, especially inflammation of the neck of the bladder, with frequent urging and scanty discharge, strangury. Urethritis with burning and purulent discharge, thick and yellow; glans penis swollen and covered with thick pus (gonorrhoea); chordee; also with oedematous infiltration of the penis and scrotum.” Digitalis is sometimes required in seminal weakness, with weak heart; involuntary emissions at night, with or without dreams. Chronic elongation of the prostate glands. Hydrocele. Amenorrhoea, with cardiac disease, and pulmonary haemorrhages. Pneumonia of old people, with prune juice expectoration, symptoms of collapse and heart failure. OEdema of the lungs and effusion into the pleural sac, with great dyspnoea and weak heart. Digitalis may be useful in jaundice; often when associated with an enlarged and indurated liver; soreness over the liver, slow or irregular pulse; urine scanty and high-colored; ashy white stools. Not useful in jaundice from retention of bile by obstruction, but when the liver fails to remove the coloring matter of bile from the blood. (In jaundice compare Myrica cerifera). Ascites from hepatic disease, with weak heart. Incarcerated hernia. Nausea and vomiting of pregnancy. Spinal anaemia resulting from seminal emissions, with the characteristic weak heart. Digitalis is often a valuable remedy in Meningitis, during the stage of effusion with dark, urine and characteristic heart symptoms; also with errors in vision, such as bright balls of fire, objects appear of various colors; later amaurotic congestion of retina, pupils dilated, and insensible to light and coma. Useful in detached retina; also in anaemia of the retina and optic nerve.
ALLEN CORSON COWPERTHWAITE was born at Cape May, New Jersey, May 3, 1848, son of Joseph C. and Deborah (Godfrey) Cowperthwaite. He attended medical lectures at the University of Iowa in 1867-1868, and was graduated from the Hahnemann Medical College of Philadelphia in 1869. He practiced his profession first in Illinois, and then in Nebraska. In 1877 he became Dean and Professor of Materia Medica in the recently organized Homeopathic Department of the State University of Iowa, holding the position till 1892. In 1884 he accepted the chair of Materia Medica, Pharmacology, and Clinical Medicine in the Homeopathic Medical College of the University of Michigan. He removed to Chicago in 1892, and became Professor of Materia Medica and Therapeutics in the Chicago Homeopathic Medical College. From 1901 he also served as president of that College. He is the author of various works, notably "Insanity in its Medico-Legal Relations" (1876), "A Textbook of Materia Medica and Therapeutics" (1880), of "Gynecology" (1888), and of "The Practice of Medicine " (1901).