The chemical composition of digitalis is complex, some of its active principles antagonizing others; the various prepa rations of digitalis differ widely in their composition and action; the so-called cumulative action of digitalis is due to its contracting the arterioles and shut ting off nutrition; it is both a, useful and a dangerous remedy, a,nd has a very limited range of usefulness; it is of use only in lesions of the mitral valve, and then only for a short time, and should be discontinued as soon as these have been overcome; it is of value as a di uretic only when there are low arterial tension and engorgement of the kidney. Digitalis decreases the excretory action of the normal kidney and impairs its nutritive activity. The tincture of digi talis, made from the fresh leaves, is the most valuable and the most certain of the preparations of digitalis. It con tains the largest percentage of those constituents which are most useful in the treatment of cardiac disease. W. H.
Porter (Amer. Medicine, Apr. 27, 1900).
investigations carried on in the Phar macological Institute in Heidelberg, and based on experiments on cats with dif ferent pure preparations of digitalis, the influence of each drug being continued for a period of several weeks. All dig italis preparations were used in grad ually increased.doscs. At first a simple therapeutic action occurred, which finally became cumulative. Digitoxin exhibited the strongest cumulative action, and is, therefore, not to be recommended for continued daily use. Digitalicurn, on the other hand, is rapidly excreted, and may be used in certain eases for considerable periods. Strophanthin is usually more evanescent in its action tban digitalis, but a preparation of strophanthin re cently prepared by Professor Thorns. of Berlin, is particularly active and lasting. In none of the preparations was there observed any tendency to become habit uated to the drug. Frankel (Amer. Medicine, May 31, 1902).