Digitalin, Digitalinum. - This is claimed not to exist as such in the drug, although that name has been given to the once supposed important content, which, in reality, is more or less complex. There are two commercial varieties: 1, German, mostly used with us, consisting of digitoxin, digitophyllin, digitalein (heart stimulants), chiefly digitonin (diuretic), digitalin and digitin (inert); yellowish-white amorphous powder, soluble in water, alcohol; 2, French - amorphous (yellowish-white, bitter powder), crystalline (needle-shaped crystals, very bitter, insoluble in water - chiefly digitoxin). Digitalin may be obtained by precipitating alcoholic extracts with tannin, washing precipitate, or by heating German variety with alcohol (4) until dissolved, adding ether (5), setting aside, evaporating ether-alcoholic solution, adding water, setting aside to deposit, washing with alcohol. Owing to its varying composition uniform doses, become impossible; usual dose gr- 1/60-1/30 (.001-.002 Gm.); crystalline, dose, gr. 1/200-1/100 (.0003-.0006 Gm.).

Preparations. - 1. Fluidextractum Digitalis. Fluidextract of Digitalis. (Syn., Fldext. Digital., Fluid Extract of Digitalis; Fr. Extrait fluide de Digitale; Ger. Fingerhutfluidextrakt.)

Manufacture: Similar to Fluidextractum Sabal, page 95; menstruum : 83 p. c. alcohol. Dose, ej-2 (.06-.13 ML (Cc.)).

Fig. 365. - Digitalis leaf: under surface.

2. Infusum Digitalis. Infusion of Digitalis. (Syn., Inf. Digit.; Fr. Tisane de Digitale; Ger. Fingerhutaufguss.)

Manufacture: 1.5 p. c. Macerate for 1 hour 1.5 Gm. with boiling water 50 Ml. (Cc.), strain, add to strained liquid cinnamon water 15 Ml. (Cc), pass through residue on strainer water q. s. 100 Ml. (Cc), mix well; must be prepared freshlv. Dose, 3ij~4 (8-15 Ml.

(Cc.)).

3. Tinctura Digitalis. Tincture of Digitalis. (Syn., Tr. Digit.; Fr. Teinture de Digitale; Ger. Fingerhuttinktur.)

Manufacture: 10 p. c Similar to Tinctura Veratri Viridis, page 101; menstruum: 75 p. c alcohol. Dose, ev-30 (-3-2 Ml. (Cc.)).

Unoff. Preps.: Abstract, dose, gr. 1/4-1 (.016-.06 Gm.). Extract (evaporate fluidextract cautiously), dose, gr. 1/6-1/2 (.01-.03 Gm.). Pilules Digitalis, Scilloe et Hydrargyri - digitalis 6.5 Gm., squill 6.5, mass of mercury 6.5, clarified honey q. s. 100 pills.

Fig. 366. - Digitalis leaf: I, epidermis of upper side seen from above with velvet hairs (h) and glandular hairs (d.h); II, epidermis of under side with stomata (sp), velvet hairs (h), glandular hairs (d.h), and the scar of a broken hair (a.h), magnified 175 diam.

While the infusion is the best diuretic, the tincture is the best for heart action; this latter, and the fluidextract, owing to alcohol present, contains most digitoxin and digitophyllin, with little gitalin - some of the digitoxin being precipitated; the extract has also digitoxin, while infusion mostly gitalin and digitsaponin.

Properties. - Cardiac tonic, vascular stimulant, diuretic, motor-excitant, paralyzant, anaphrodisiac, sedative, narcotic, emetic; normal doses make the pulse slower, firmer, stronger. The diastole (periodic dilatation) is prolonged, owing to stimulation of the pneumogastric; the systole (periodic contraction) is not altered as to duration, but is in degree, the force being increased greatly, owing to stimulation of the heart muscle and its contained ganglia, which may be so powerful as to squeeze out all of the blood, thus causing death in systole by overstimulation. Temperature is lowered by the lessening of blood supply to the tissues. Blood-pressure in the glomeruli of the kidneys is increased, causing diuresis. Recumbent position is best when under its influence. The rapid pulse is due to over-stimulation of the pneumonic (inhibition) and consequent exhaustion, thus allowing the sympathetic alone to control the action. Digitalis and aconite slow the heart, otherwise are antagonistic; the former increases inhibition, stimulates motor apparatus; the latter does the converse, thus weakening the beat, both finally paralyze cardiac ganglia - digitalis by over-stimulation, aconite by direct depression. Arterial tension is raised by digitalis, lowered by aconite; the latter acts quickly, the former slowly, possessing cumulative action - i. e., several doses given at proper intervals may show no result until suddenly the combined action of all the doses is manifested at once, proving sometimes fatal if not very cautious. In consequence of this, aconite becomes a more valuable antagonist in digitalis-poisoning than digitalis in aconite-poisoning.

Uses. - Where heart is rapid and feeble, deficient and poor circulation (as it causes the heart to expel much more blood than normally), renal disease, venous engorgement, dropsy, pneumonia, scarlet fever, congestive headache, hemicrania in mania, delirium tremens, hemorrhages, menorrhagia, rheumatic fever, spermatorrhoea, pleurisy, pericarditis, chronic bronchitis, epilepsy. Locally to enlarged glands, abdominal and renal dropsy.

Poisoning: Have sneezing, nausea, vomiting of mucus, bile, and dark green matter, colic, purging with severe pain, headache; heart beats violently, but pulse small and shallow, yet upon rising rapid, weak, and irregular; vertigo, yellow vision, face pale, pupils usually dilated, sometimes contracted, eyeballs protruding, sclerotic blue colored, pain in back and limbs, diarrhoea, suppressed urine, salivation, conscious until near the end, delirium, coma, convulsions, death suddenly by paralysis of heart muscle. Wash out stomach with warm water and tannin, give diffusible stimulants (injections), aconitine (best to antagonize large quantities of digitalis), opium (best to antagonize long usage of digitalis), saponin, senegin (best physiological antagonist), Epsom or Rochelle salt, fluidextract of quillaja, and senega, external heat, horizontal position.

Incompatibles: Cinchona, tannin, iron sulphate, lead acetate, tincture of ferric chloride, syrupy and watery solutions, which may decompose drug's active principles.

Synergists: Cardiac stimulants, belladonna, ergot, etc.