Case of a man who bad valvular de fect of the heart. He improved on dig italis, and after passing from medical observation continued to employ this drug,. This failed to control the condi tion, and the patient died. The doses that were employed toward the latter part of his life were enormous. It was estimated that in the course of five years he consumed between 500 and 600 grannnes (16 J/3 and 192/, ounces) of the drug. C. Schubert (.Miinchener med. Wochen., Sept. 23, 1902).
In arteritis digitalis is a powerful auxiliary, assisting to control the mor bidly increased action of the heart and arteries, but it should not be used to the exclusion of general antiphlogistic measures.
It is generally said that digitalis does harm in aortic regurgitation, and good in obstructive 'ultra' disease; but it is better to rely on symptoms rather than on the nature of the valvular lesions as indications for the administration of the drug. A rough-and-ready rule, which works well in practice, is that digitalis Call be given when the pulse is irregular or intermittent and the mine scanty. Remember that the freshly-prepared in fusion is a better preparation than the tincture. Lond. ("Manual of
Mat. Med. and Therap.," '96).
Some consider digitalis is beneficial in mitral obstruction, while others hold it is indicated more especially 1/1 mitral re gurgitation. It has been observed of eminent service in cases where, after death, the symptoms were seen to be due to mitral regurgitation, and little, if at all, to mitral obstruction. One should try digitalis in every mitral ease, even in pure mitral stenosis. Inefficiency may be due to irregularity arising from fatty degeneration; and the indications for its use are less conspicuous in aortic disease with insufficient compensation than in purely mitral cases, though in failing heart from aortic disease it may render excellent service. In irritable heart where much hypertrophy exists, digitalis may prove serviceable, and may totally fail to afford any relief. It is often valuable in quelling attacks of pal pitation. It is useful in fatty heart and arterio-capillary fibroses inducing hy pertrophy of left ventricle. Ringer and Sainsbury ("Hand-book of Therap.," '97).