As a, diuretic, digitoxiu is superior to digitalin, since it actually dilates the renal vessels, while stimulating the heart. Furthermore, its aation is prompter and more certain than that of digitalin. It manifests its effects oftentimes within twelve hours, and is less liable to cumulative action than digitalin. Masius has used as much as 1/,,, grain a day. After discontinuing the use of the drug the influence of digitoxin is said to persist, sometimes, for eight to ten days. To avoid di gestive disturbance, Wenzel employed it chiefly by enema, giving about '/8,, grain in 10 minims of alcohol and 4 ounces of water. The action upon the heart, as observed in these experiments, was quite pronounced; at first three rectal injections were given daily (pre vious thorough cleansing of the bowel being presupposed), afterward only two injections were used, and, finally, only one was found necessary, in order to maintain the first effect produced. In personal experience digitoxin has been given in a series of cases—of late, chiefly hypbdermically, but also by the mouth (always after meals). It .was tile ex
ception to see any digestive disturbance when lh,„ grain or less of digitoxin was being given three times daily. In no case did an abscess ever result from the hypodermic syringe.
Digitoxin has been especially recom mended in chronic myocarditis and in cases of ruptured compensation.
A solution of digitoxin is liable to precipitate on coming in contact with the secretions of the body. To avoid this, and yet not use too much alcohol in the pharmaceutical preparation of the solution, it has been recommended to add a little chloroform to the solu tion. The following solution has, after experimentation, been found to be stable, and will not precipitate upon contact with blood-serum, water. or s imn-chloride solution:— Digitoxin, grain.
Chloroform, 1 V, Alcohol at 90 per cent., 23 minims. Water, sufficient to make 1/2 ounce.—M.
L. L. Solomon (N. Y. Med. Jour., Feb. 9, 1901).