Strophanthus. This active agent is of value if used with discrimination, but a few cautions are advisable. Do not prescribe the tincture in an aqueous medium, since the glucoside is precipitated. As it is customary to have patients use so many drops in water, it is the best plan to use the U. S. P. tincture and not the fluidextract or eclectic tincture. The tincture is double its former strength, and the average dose is 8 I. It is seldom advisable to exceed I5 or 20 I. Remember that strophanthus acts directly upon the heart muscle, increasing the systole and slowing the pulse without vasomotor effects. It is contraindicated in active hyperemia, visceral hemorrhages, vasomotor disturbances, and the ascites of tumors. Give strophanthus when the heart muscle is weak and the pulse rapid without pyrexia. It is indicated in valvular lesions incident to muscular weakness and in dyspnea. Persistent anemia, due to a weak heart, and acute anemia following uterine hemorrhage, are aided, and ofttimes most materially benefited, by strophanthus.

In small doses (tr., I to 3 I.) it is useful in the irritable heart of tobacco smokers in arteriosclerosis. In exophthalmic goitre it has been highly commended. Begin with small doses and run up to 8 or 10 drops. Some cases of urticaria yield to a similar course of treatment.