Digitalis purpurea

WEAKNESS, faint-like; can hardly talk. Heart slow, with indefinite or causeless symptoms. HEART SLOW, weak or irregular; quick, on motion; with liver or sexual symptoms; at puberty. Must walk about, with precordial anxiety; with teasing to urinate. .................... Anxious solicitude. Dizzy. Crashes in head; on dropping to sleep. Spastic hemicrania. Yellow- red conjuctiva. Seething in ears. Face pale; bluish, also lips and tongue. Thick, flabby tongue. Much thirst, little appetite (Sul.), but no fever. Deathly nausea or with faint sinking at pit of stomach. Liver sore, swelled. White, putty-like stools. Dribbling urination. Dropsy. Throbbing in neck of bladder. Early morning erection. Swelled prostate; senile. Atonic night losses. Glans inflamed; gonorrhœa of (Jaca.). Profuse, thick, yellow-white gonorrhœa. Slow breathing. Cough, with pains in shoulders and arms. HEART; weak; feels like stopping; sprains; palpitation. Slow, intermittent pulse. Numb or weak left arm. Drowsy. Dreams of falling; wakes with a shock. Cold skin. Flushes of heat, then great weakness. Cold, clammy sweat.

Raising up. Exertion. Heat. Lying on L. side. Motion. Smell of food. Cold drinks. Excesses: Sexual.

Rest. Cool air. Lying flat on back.

Vagus. HEART; muscle. CIRCULATION: Liver. Lungs. Stomach. Occiput. Genito-urinary organs.

Related: Glo. Spi.

Digitalis purpurea

Foxglove. Scrophulariaceae.

Sudden flushes of heat, followed by great nervous weakness and irregular intermitting pulse, occurring at the climacteric; < by least motion.

Weak heart without valvular complications. Sensation as if heart would stop heating if she moved (Cocaine — fears that unless constantly on the move heart will cease beating. Gels.).

Faintness or sinking at the stomach; exhaustion; extreme prostration; feels as if he were dying.

Nightly emissions, with great weakness of genitals after coitus.

Great weakness of chest, cannot bear to talk ( Stan. ) .

Stools : very light, ash-colored ; delayed, chalky (CheL, Pod.) ; almost white (Cal., Cinch.) ; pipe-stem stool; involuntary.

Pulse full, irregular, very slow and weak; intermitting every third, fifth or seventh beat.

Face pale, deathlike appearance and bluish-red.

Bhieness of skin, eyelids, lips, tongue; cyanosis.

Distended veins on lids, ears, lips and tongue.

Respiration irregular, difficult, deep sighing.

The fingers “go to sleep” frequently and easily.

Dropsy : post-scarlatinal ; in Bright’s disease ; with suppression of urine; of internal and external parts; with fainting when there are organic affections of the heart (with soreness in uterine region, Conv.).

Fatal syncope may occur when being raised to upright position.

Relations. — Cinchona antidotes the direct action of Digitalis and increases the anxiety.

Aggravation. — When sitting, especially when sitting erect; motion.

Lecture XXXVII — Scrophulariaceae — Digitalis purpurea, Linaria vulgaris, Verbascum, Gratiola, Leptandra virginica and Euphrasia

Scrophulariaceae f Myrica cerifera.

| Spigelia.

Kalmia.

j Helleborus.

^ < China.

Digitalis.

Gratiola.

Leptandra.

Euphrasia.

Verbascum.

Linaria.

From this order of plants we obtain Digitalis, Gratiola, Leptandra Virginica, Euphrasia, Verbascum and Linaria. These drugs are not all thoroughly proved, but those that are well known are sufficiently distinct to be easily remembered. The most important member of the group is the

Digitalis Purpurea.

Digitalis contains among other ingredients two substances, one known as Digitalin, the other as Digitoxin. The latter is found in larger quantity than the former. Digitalin has been proved separately from the Digitalis. Its symptomatology, however, is, like most other active principles, very nearly identical with that of the original drug. Digitalis produces, very early in the proving or in poisoning cases, among other symptoms, the most distressing nausea and vomiting. This emesis is often accompanied by a deathly faint, sinking sensation at the pit of the stomach. The surface of the body is often cold, and sometimes covered more or less with cold sweat. The pulse is irregular. These early symptoms of Digitalis remind one of several other drugs, notably, Antimonium tartaricum, Tabacum and Lobelia. It is probable that these drugs and Digitalis all cause this nausea and vomiting by affecting the base of the brain, acting there upon the pneumogastric nerves as they leave their origin. Such symptoms as this deathly nausea and vomiting might suggest the use of Digitalis in the vomiting attendant upon cerebral disease; in meningitis, for instance, whether the meninges of the cerebrum alone, or of the cerebrum and cord combined, were involved in the inflammation.

The drug may even be used in the nausea and vomiting of pregnancy, and in the incipiency of abortion. One of the provers, a pregnant woman, took an overdose of Digitalis, and in consequence was seized with this same deathly nausea and a flow of blood from the vagina.

We may also study Digitalis in its action on the heart. Through irritation of the pneumogastric nerves we have inhibition of the heart's action. As a consequence of this effect of the drug, the pulse becomes slow. Arterial tension is greatly increased, probably owing to the action of the drug on the vaso-motor centre, which is supposed to be at the base of the brain; the pulse is, therefore, primarily slow and strong. In addition to the effect of the drug on nervous structure, we must remember that it also affects muscular tissue, both of the striated and non-striated varieties. Thus it causes weakness of the cardiac tissues. This weakness varies in intensity from simple weakness to complete paralysis of the muscular fibre. Consequently, we may very soon have added to these other symptoms, weakness of the pulse. Every little extra exertion, such as that incurred while rising from a sitting to a standing posture, increases the rapidity of the pulse, but the force of the beat is diminished. This quick pulse may become irregular and even intermittent. With this view, then, of the physiological action of the drug, you may understand the following symptoms of the heart and respiration connected therewith.

But first let me here give you a word of caution respecting the use of Digitalis in heart affections. The tendency of this drug, like that of Lachesis and Arsenicum album, is downward. You must not use it, therefore, indiscriminately or carelessly, but only when you are guided to its selection by the symptoms of the case, or you will certainly make your patient worse. In organic diseases of the heart, Digitalis must be used with extreme caution, because it may hasten the period when nature is no longer able to compensate by hypertrophy of the heartmuscle for the interference in the circulation. Nature thus may be compelled to give out. Then the heart yields to the pressure of the blood within its cavities and begins; and we shall have the train of symptoms which I intend to describe to you shortly, as belonging to Digitalis. This warning is particularly applicable to the use of the drug in large doses. Given thus it may relieve for a time, but it only hastens the fatal end. With this word of warning I now proceed to give you in detail the heart symptoms of Digitalis.

The heart feels as though it stood still, and this sensation is attended with great anxiety. There is a sort of indescribable uneasiness in the cardiac region, which may be expressed as a sense of oppression or tightness about the heart, or as an uneasy feeling with weakness and numbness in the left arm. There is a feeling of goneness or sinking at the epigastrium. This is sometimes relieved by eating, but often comes on worse after eating, particularly after breakfast. There are sharp sticking pains in the region of the heart. Sometimes there is choking when trying to swallow, from reflex spasm of the glottis. The pulse is slow, often slower than the beating of the heart. In these cases the heart beats so imperfectly that some of its pulse waves are not transmitted appreciably to the radial artery at the wrist. Any movement such as rising from a chair, getting out of bed, or increasing the speed in walking, increases the rapidity of the pulse but causes no increase in the force of its beat. The irregular distribution of the blood caused by these alterations in the heart's functions is exhibited in a variety of sympjtoms. In extreme cases, for instance, we find even cyanosis, which suggests Digitalis as a possible remedy for cyanosis neonatorum. The child turns blue and falls into a syncope on the slightest motion, or else it becomes deathly sick, as you see from the expression of the face and from the involuntary gagging. If you can feel the pulse, you will find it irregular both in rhythm and volume; the surface of the body is cool. The borders of the lips are blue or purple. The child is blue around the eyes. The veins wherever they show through the skin are seen to be dark.

Other and more common illustrations of the irregular distribution of the blood may be shown in the sleep. The patient's sleep is uncomfortable and restless. He dreams a great deal; he starts up from sleep dreaming that he is falling from a great height. Sometimes he awakens with an anxious or distressed feeling, which he may be unable to locate, but which results from the cardiac affection. Mentally, the Digitalis patient, besides being anxious, has those gloomy forebodings incident to heart disease. He has an apprehensive feeling, ill-defined it is true, yet none the less terrible. He is apt to be sad and depressed, as well as anxious. The respiration is of course affected by this action of the heart. We frequently find the breathing deep, sighing and slower than normal. This symptom is almost pathognomonic of heart affection. There is often a desire to take a deep breath, but an attempt to do so seems to result in only half-filling the lungs, which do not expand to their full capacity. This is often attended with dry cough, which seems to be excited by deep inspiration. The deeper he attempts to breathe, the more likely is he to cough. This is altogether a bronchial symptom, and comes on from an overfilling of the blood-vessels there. Suffocative spells with painful constriction of the chest, as if internal parts of the chest were grown together, are not uncommon. Sometimes these attacks force the patient to sit up in order that he may breathe. If these cardiac symptoms are present you will find Digitalis indicated in several varieties of disease starting remotely from the heart, and yet depending for their existence either directly or indirectly upon the disease of that organ. In almost all the affections in which Digitalis may be used there is present either a slow pulse or a feeble pulse, becoming irregular or quick.

For instance, dropsy may call for Digitalis. This dropsy is not of renal origin. You would hardly think of Digitalis in dropsy resulting primarily from a liver or kidney disease, but in that form occurring primarily from cardiac debility, it is at times an invaluable remedy. Digitalis may be used with profit in a number of forms of dropsy. You may give it in anasarca when the surface of the body is bluish, rather than of the alabaster-like appearance characteristic of renal dropsies. Local dropsies, too, are present. Thus you find Digitalis indicated in hydropericardium, and even in hydrothorax and ascites, if they are connected with heart disease. In dropsies of the chest there is a remedy that is often forgotten, and that is the Sulphate of Mercury or Mercurius sulphuricus. Especially is this remedy useful when the chest-dropsy occurs from heart or liver disease. When the drug acts well it produces a profuse watery diarrhoea, with great relief to the patient. A very common form of dropsy calling for Digitalis, is infiltration of the tissues of the scrotum and penis. We may even use Digitalis in hydrocele when the cardiac symptoms calling for the remedy are present. The urine is often suppressed or very scanty. This deficiency in the renal secretion depends upon disordered circulation, and not upon primary disease of the kidneys. The urine may be dark red or albuminous.

We find Digitalis causing some liver symptoms which are worthy of notice. I think, however, that Digitalis has no direct action on the hepatic cells; it does not appear to affect the bile secretion directly. But in jaundice, in which the primary trouble is a cardiac disease of the type already mentioned, with ashy white stools, Digitalis certainly acts admirably. The liver is enlarged and feels sore, as if bruised. Objectively examined, it is found to be somewhat indurated. With this symptom we have jaundice. The taste is bitter, or at other times, sweetish. The tongue may be perfectly clean, or it may be whitishyellow. The pulse is slow, even slower than the beating of the heart. Drowsiness may supervene and even increase to stupor. The stools are of the character above mentioned. The urine is high-colored from admixture of bile pigment. The jaundice calling for Digitalis is not that which follows retention of bile or is caused by catarrh of the duodenum or by some obstruction of the biliary ducts, but it is due to an actual functional imperfection of the liver, that organ not taking from the blood the elements which go to form the bile.

A remedy which here compares favorably with Digitalis is Myrica cerifera, which has the following symptoms. First, despondency, which depends upon the disordered condition of the liver. The symptoms of Myrica are similar to those of Digitalis because in each case the jaundice is due to the imperfect formation of bile in the liver, and not to obstruction of the flow. But the two remedies are very different in their absolute effects on the system. With Digitalis, the jaundice is traceable to the condition of the heart. With Myrica, the case seems to be functional rather than organic. For some reason the bile is not properly formed, and therefore its elements remain in the blood. The heart is affected secondarily, slowness of the pulse thus being produced. The S3'mptoms calling for Myrica are these: Despondency, dull, heavy headache, worse in the morning; the eyes and sclerotic have a dirty, dingy, yellowish hue, the lids themselves being abnormally red; the tongue is coated a dirty yellow. Weak sinking feeling in the epigastrium after eating. The patient is weak and drowsy, and complains of muscular soreness and aching in the limbs. The pulse is slow but intensified. The stools are ash colored. The urine is dark and turbid. You recognize at once the resemblance to Digitalis; but it is more superficial in its action than is that remedy, and would not be suitable for so violent a case as the latter.

In heart affections you may compare Digitalis with a number of remedies, notably, with Kalmia, Arsenicum album, Helleborus and Conium.

Kalmia latifolia is a drug which belongs to the order Ericaceae, with Rhododendron, Ledumpalustre and other remedies. It is a valuable remedy in rheumatism when it affects the chest. The pains in the Kalmia affection of the heart are sharp, taking away the breath; the patient almost suffocates, so severe are they. The pains shoot down into the abdomen or stomach; the pulse is slow, almost as slow as that calling for Digitalis. Kalmia is especially useful when gout or rheumatism shifts from the joints to the heart, especially after external applications to the joints. I refer here especially to the application to the joints of substances that are not homoeopathic to the case. If you were giving Arnica internally and applying it locally, and if it were the indicated remedy, there would be no danger of metastasis. But if some one were to apply the tincture of Aconite to the affected joint there would be danger of the inflammation travelling to some more vital part. The Kalmia rheumatism, unlike that of Ledum, usually travels downward, thus following the direction of its pains. Helleborus is similar to Digitalis in the slowness of the pulse. The respiration is also slow and the temperature of the body is greatly diminished, often being as low as 95 or 96 F. There is generally cerebral disease.

Spigelia also must be compared with Digitalis. It has the following symptoms. Sharp pain shooting through the heart to the back, or radiating from the heart and down the arm or over the chest and down the spine; great oppression or anxiety about the heart; palpitation of the heart worse from any movement of the arm or body; thrilling or purring sensation felt over the cardiac region (this is just such a thrill as you feel when stroking a cat's back when the animal is purring); blowing sound over the heart. You will find Spigelia indicated when these heart symptoms accompany other affections, for instance, neuralgia, particularly if it affects the left side of the face, commencing in the occiput and settling over and in the left eye. That is the Spigelia headache. Its aggravation follows the course of the sun. It commences in the morning, reaches its acme at noon, and diminishes toward night. You may also use it in ciliary neuralgia with these accompanying sympathetic symptoms of the heart. Sharp pain shoots through the eyeball and radiates in all directions, almost driving the patient mad. At other times there is a sensation as if the eye were being squeezed in a vise or as if it were enormously enlarged and were being pushed out of the head. It is one of the chief remedies to be thought of in iritis with excessive pain. I wish also to mention a symptom for Spigelia that the late Dr. Jacob Jeanes confirmed many times, and that is intermittent pulse. He prescribed this remedy as an intercurrent, in many varieties of disease, when the pulse assumed this character.

Convallaria majalis presents heart symptoms associated with uterine symptoms; soreness in the hypogastrium; pain in the sacro-iliac synchondrosis, extending down the leg. Itching of the meatus urinarius and vulva.

Another remedy is Magnolia gra7ialiflora , which has sadness; nervousness; weak heart, with sensation of constriction in the cardiac region; worse on walking fast; and at times the sensation as if the heart stopped beating.

It will not be unprofitable for us next to study the action of Digitalis on the brain. It causes symptoms which are very much like those of meningitis, even meningitis with effusion, or of hydrocephalus, and also of cerebro-spinal meningitis. The symptoms from which you will have to decide are these: there is throbbing headache, which is referred to the forepart of the head; delirium, which may be so violent as to simulate mania; decided errors in vision; bright balls of fire appear in the field of vision, or, like Santonin, objects appear of various colors, as yellow or green. Still later, as the trouble progresses, mental confusion increases and amaurotic congestion of the retina takes place; the pupils become dilated and fail to respond to light, and finally coma appears. There is great general prostration with coldness of the body, which is covered with a cold sweat. Even in these forms of cerebral disease, when Digitalis is to be your remedy, the pulse comes in as your chief guide. If the symptom, buzzing in the ears, should suggest Cinchona, I entreat you not to give it after Digitalis, for Hahnemann tells us that, although there is a similarity in the cerebral symptoms and in the weakness, yet the drugs are inimical. Lastly we shall speak of the action of Digitalis on the urethra and genital organs. Digitalis produces a catarrhal irritation of the bladder, particularly about its neck. There are strangury and frequent urging to urinate, especially when the patient is standing or sitting; pressure on bladder not relieved by urinating. The patient may also have frequent urging to urinate at night. The urethra is inflamed so that we have burning in the urethra with purulent discharge, thick in character and bright yellow in color. Now, if you combine these symptoms with another one, namely, that the glans penis becomes inflamed with copious secretion of thick pus over its surface, you have a perfect picture of Digitalis in gonorrhoea. This form of the trouble, Digitalis will cure, whether the pulse be slow, fast, soft, weak, or what not. Often, too, when Digitalis is indicated in this trouble, you will find the prepuce puffed up and infiltrated with serum. Let me say, in passing, that if the prepuce becomes indurated, Digitalis will do no good, but Sulphur will.

The nearest remedy to Digitalis in gonorrhoea is Mercurius. This is a good remedy for gonorrhoea associated with inflammation of the prepuce, but with less oedema and more dark purplish swelling of the parts with phimosis or paraphimosis.

Mercurius corrosivus is good in these cases when the glans has a dark red or gangrenous appearance.

In the beginning of these cases of paraphimosis, we may give Colocynth, which will sometimes relieve the spasm and enable the prepuce^ to be drawn forward over the glans.

Petroselinum is to be thought of as an intercurrent remedy in gonorrhoeal affections when the neck of the bladder is involved, and there is sudden urgent desire to urinate. It seems as if the patient can hardly retain his urine until he gets to a convenient place.

Digitalis also produces violent erections, even chordee. It is one of our best remedies for involuntary seminal emissions during sleep, even without dreams. The emissions are followed by great weakness.

Despondency; fearful; anxious about the future. Dullness of sense. Every shock strikes in epigastrium. Melancholia, dull lethargic with slow pulse.

Comes into play in all diseases where the heart is primarily involved, where the pulse is weak, irregular, intermittent, abnormally slow, and dropsy of external and internal parts. Weakness and dilatation of the myocardium. Its greatest indication is in failure of compensation and especially when auricular fibrillation has set in. Slow pulse in recumbent posture, but irregular and dicrotic on sitting up. Auricular flutter and fibrillation especially when subsequent to rheumatic fever. Heart block, very slow pulse. Other symptoms of organic heart disease, such as great weakness and sinking of strength, faintness, coldness of skin, and irregular respiration; cardiac irritability and ocular troubles after tobacco; jaundice from induration and hypertrophy of the liver, frequently call for Digitalis. Jaundice with heart disease. Faint, as if dying. Bluish appearance of face. Cardiac muscular failure when asystole is present. Stimulates the heart's muscles, increases force of systole, increases length. Prostration from slight exertion. Collapse.

Worse, when sitting erect, after meals and music. Better, when stomach is empty; in open air.

Vertigo, when walking and on rising, in cardiac and hepatic affections. Sharp, shooting frontal pain, extending into nose, after drinking cold water or eating ice-cream. Heaviness of head, with sensation as if it would fall backward. Face bluish. Confusion, fullness and noise in head. Cracking sounds during a nap. Blue tongue and lips.

Blueness of eyelids. Dark bodies, like flies, before eyes. Change in acuteness of perception of shades of green. Objects, appear green and yellow. Mydriasis; lid margins red, swollen, agglutinated in morning. Detachment of retina. Dim vision, irregular pupils, diplopia.

Sweet taste with constant ptyalism. Excessive nausea, not relieved by vomiting. Faintness, great weakness in stomach. Burning in stomach extending

to œsophagus. After cold water or ice-cream, sharp pain in forehead, extending to nose. Faintness and vomiting from motion. Discomfort, even after a small quantity of food, or from mere sight or smell. Tenderness of epigastrium. Copious salivation. Neuralgic pain in stomach, unconnected with taking food.

Pain in left side apparently in descending colon and under false ribs. Severe abdominal pains, pulsation in abdominal aorta, and epigastric constriction. Enlarged, sore, painful liver.

White, chalk-like, ashy, pasty stools. Diarrhœa during jaundice.

Continued urging, in drops, dark, hot, burning, with sharp cutting or throbbing pain at neck of bladder, as if a straw was being thrust back and forth; worse at night. Suppressed. Ammoniacal, and turbid. Urethritis, phimosis, strangury. Full feeling after urination. Constriction and burning, as if urethra was too small. Brick-dust sediment.

Nightly emission (Digitalin), with great weakness of genitals after coitus. Hydrocele; scrotum enlarged like a bladder. Gonorrhœa, balanitis (Merc), with œdema of prepuce. Dropsical swelling of genitals (Sulph). Enlarged prostate.

Labor-like pains in abdomen and back before menses. Uterine hæmorrhage.

Desire to take a deep breath. Breathing irregular, difficult; deep sighing. Cough, with raw, sore feeling in chest. Expectoration sweetish. Senile pneumonia. Great weakness in chest. Dyspnœa, constant desire to breathe deeply, lungs feel compressed. Chronic bronchitis; passive congestion of the lungs, giving bloody sputum due to failing myocardium. Cannot bear to talk. Hæmoptysis with weak heart.

The least movement causes violent palpitation, and sensation as if it would cease beating, if he moves (Opposite; Gels). Frequent stitches in heart. Irregular heart especially of mitral disease. Very slow pulse. Intermits; weak. Cyanosis. Inequality of pulse; it varies. Sudden sensation as if heart stood still. Pulse weak, and quickened by least movement. Pericarditis, copious serous exudation. Dilated heart, tired, irregular, with slow and feeble pulse. Hypertrophy with dilatation. Cardiac failure following fevers. Cardiac dropsy.

Swelling of the feet. Fingers go to sleep easily. Coldness of hands and feet. Rheumatic pain in joints. Shining, white swelling of joints. Muscular debility. Nocturnal swelling of fingers. Sensation in legs as if a red hot wire suddenly darted through them (Dudgeon).

Erythema, deep red, worse on back, like measles. Blue distended veins on lids, ears, lips and tongue. Dropsical. Itching and jaundiced.

Starts from sleep in alarm that he is falling from a height. Continuous sleepiness.

Sudden flushes of heat, followed by great nervous weakness.

Antidotes: Camph; Serpentaria. Incompatible: China. Compare: Nerium odorum (resembles in heart effects Digitalis, but also has an action like Strychnia on spinal cord. Spasms appear more in upper part of body. Palpitation; weak heart will be strengthened by it. Lock-jaw). Adonia; Cratægus (a true heat tonic); Kalmia; Spigel; Liatris; Compare also; Digitoxinum (Digitalis dissolved in Chloroform; which has yellow vision very marked, and distressing nausea, aggravated by champagne and aerated waters). Nitri spir dulc increases action of Digit. Ichthyotoxin. Eel Serum (Experiments show great analogy between the serum and the venom of vipera. Indicated whenever the systole of the heart is insufficient, decompensated valvular disease, irregular pulse due to fibrillation of the auricle. Assytole, feeble, frequent, irregular pulse, dyspnœa and scanty urine. Liver enlarged, dyspnœa, albuminuria. No œdema). Convallaria (heart disease with vertigo and digestive disturbances). Quinidin-Isomeric methoxyl compound.––(Restores normal rhythm in auricular fibrillation, often supplements the action of Digitalis. Two doses of 3 grains each, three hours apart-if no symptoms of cinchonism develop, 4 doses 6 grs each daily (C. Harlan Wells). Paroxysmal tachycardia. Establishes normal heart rhythm at least temporarily, less in valvular lesions).

The third to thirtieth attenuation will bring about reaction when the drug is homeopathically indicated; but for palliative purposes the physiological dosage is required. For this purpose, the tincture made from the fresh plant, in doses of five to twenty drops, when the cardiac stimulation is desired, or the infusion of 1 1/2 per cent. Dose, one-half to one ounce if the diuretic action is wanted. The tincture may be given on sugar or bread, and nothing liquid be taken for twenty minutes before or after its administration. Of the powdered leaves, 1/2 to 2 grains in capsules. Digitoxin 1-250 grain. No matter what form of digitalis is given the dose should be reduced as soon as the pulse rate has been lowered to 80 beats a minute and the normal rhythm has been partially or completely restored. Under such conditions a good rule is to cut the dose in half and still more if there be a sudden falling off of the urinary output.

Digitalis

History: This drug as used by the Old School has done more mischief than any one drug in their Materia Medica. Every patient who had a fast heart, or anything the matter with the heart, was given Digitalis.

It has caused more deaths than any drug. If administered when the heart is going fast it will soon produce a peculiar kind of paralysis; the heart then having lost its balance-wheel, compensation gives out, the patient sinks and finally dies.

They do not know that many patients would have lived through fevers, pneumonia and other acute diseases if it had not been for this medicine, used as they have used it in the tincture, in many-drop doses, until the heart was slowed down.

They call it sedative; yes, it is a sedative. It makes the patient very sedate. You have seen how very sedate a patient looks after he has been in the hands of an undertaker and has on his best garments. That is what Digitalis does. In that way it is a sedative in the hands of the allopath. A homoeopathic physician never prescribes to bring down the pulse. He prescribes for the patient and the heart's action takes care of itself.

Digitalis is a very poor fever medicine. Instead of being indicated when the pulse is fast, the proving says it is indicated when the pulse is slow. The allopath gives it when the pulse is fast to make it slow; if given to a well person it will make the pulse slow, and when indicated in a sick person the pulse is slow.

Liver: It produces a great disturbance of the liver.

"Congestion and enlargement of the liver. Soreness of the liver."

Tenderness about the liver-but during that time the pulse is slow. It makes the bowels very sluggish, produces inactivity of the liver, and stools are bileless, light colored, putty-like-and the pulse is slow.

Add to that jaundice and you have a grand picture of Digitalis: jaundice with slow pulse, with uneasiness in the liver, pale stool, and even if you have never seen or beard of Digitalis before you will scarcely miss it. Now, you might add a myriad of little symptoms, but it does not change the aspect of things. It is Digitalis.

Stomach: Another group of symptoms that belongs with the Digitalis heart, the Digitalis liver and the Digitalis bowels, is a gone, sinking feeling in the stomach. It seems as if be would die, and he does not get better from eating. It is a nervous, deathly sinking that comes with many heart troubles.

You would not be surprised to find in Digitalis much nervous prostration. Restlessness and great nervous weakness.

"Feels as if would fly to pieces.

Anxiety.

Feels that something is going to happen." Seems as if his whole economy were full of anxious feelings and restlessness. Lassitude, faintness exhaustion and extreme prostration. Faints on the slightest provocation. It begins in the stomach; an awful sensation of weakness in the stomach and bowels.

Sleep: His sleep is full of horrible dreams, nightmare, fright. Dreams of falling, that is very common with cardiac affections. When the pulse is too slow, when it is irregular, the brain is irregularly supplied with blood during sleep, and there is a turbulent state.

A shock goes through the body like an electric shock, like internal jerkings, twitchings. Sudden muscular movements, as if a current of electricity passed through the body. This, with slow pulse, with a sense of faintness, and great weakness. Bluish paleness of the lips in persons who suffer at times with cardiac spells - it seems at times as if the pulse would cease. Face becomes blue, the fingers become blue. Wants to lie on the back. Frequently startled in sleep; jerking at night.

The heart symptoms are numerous, but none is so important as the slow pulse. The pulse is slow in the beginning of the case. It may now be flying like lighting.

Pulse: He is anxious, restless, has horrible dreams and sinking in the stomach - that sounds like the advanced stage of Digitalis - but I want to know if in the beginning, the pulse was slow. The patient himself seldom knows, but someone says that in the beginning the pulse was 48; that is Digitalis. If the pulse in the beginning was rapid do not think of Digitalis, for it will not do any good.

The Digitalis pulse is at first slow and perhaps remains so for many days, until finally the heart commences to go with a quiver, with an irregular beat, intermits, feels as if it would cease to beat, and then we have all these strange manifestations.

Weakness is the very character of the Digitalis pulse, and all these characteristics go along with it. First it is slow, and sometimes strong. Slow, strong pulse when rheumatism is threatening the heart.

"Violent. but not very rapid pulse.

Sudden violent beating of the heart, with disturbed rhythm."

The slightest motion increases anxiety and palpitation. When the pulse is going very slow, sometimes down to 40, the patient turns the head and the pulse flutters and increases in its action. If he turns over in bed it seems as if the heart would stop. If he moves he feels it fluttering all over him, and it settles back and is slow again; but, finally, it changes and flutters all the time.

Palpitation of the heart originating in grief. Sudden sensation as though the heart stood still. Fluttering of the heart, The least muscular exertion renders the heart's action labored and intermittent in a feeble heart.

Cough: A person with an enlarged liver, with a slow pulse, with jaundice and pale and stool. With that he will have a troublesome cough. Digitalis is not much of a remedy for a cough unless it is a cardiac cough.

Cough at midnight. Cough, with expectoration of "boiled starch." Cough, with expectoration of bloody mucus in hypostatic congestion of the lungs.

Cough, brought on by talking, walking, drinking anything cold, bending the body. These are coughs associated with other troubles.

Respiration: The same thing is to be said of the respiration. There are difficulties of respiration, along with cardiac troubles and liver troubles. "Respiration irregular and performed with great difficulty.

Constant desire to take a deep breath. When he goes to sleep the breath seems to fade away, then he wakes up with a gasp. Lachesis, Phosphorus, Carbo veg. and some other remedies have that; remedies that affect the cerebellum particularly, producing a congestion of the cerebellum.

When a patient goes to sleep the cerebrum says to the cerebellum:

"Now you carry on this breathing a little while, I am getting tired."

But the cerebellum is not equal to the occasion. It is congested, and just as soon as the cerebrum begins to rest the cerebellum goes to sleep, too, and lets the patient suffer; and in that way we get suffocation. The cerebellum presides over respiration during sleep and the cerebrum presides over respiration when the patient is awake. We might learn that from the provings of medicines if we never found it before. "Fear of suffocation at night."

Now, to analyze that. He knows from experience that every time he drops into a sleep he suffocates, and hence he fears to go to sleep for fear he will suffocate. The fear of suffocation at night is from this origin. It is the same if he falls asleep in the day time.

"Can only breathe in gasps."

Digitalis is a useful medicine when there is a filling up of the lower part of thy lungs. The patient is sitting up in bed, and there is dullness in the lower part of each lung and plenty of resonance in the upper portion. Then it is, if he lies down, he will suffocate. Digitalis likes mostly to lie flat on the back with no pillow, when there is no filling up of the lungs. But when there is hypostatic congestion he suffocates. If early in the case the pulse was slow and it has become fast, Digitalis may be of some benefit.

Urinary organs: Now, a feature in connection with the genito-urinary organs. In old cases of enlarged prostate gland I do not know what I would do without Digitalis. Where there is a constant teasing to pass urines.

In many instances where the catheter has been used for months or years because he is unable to pass urine in a natural way, and where there is a residuary urine in old bachelors and old men, Digitalis is a good remedy.

It diminishes the size of the prostate gland and has many times cured.

"Dropsy with suppression of urine."

In uraemic poisoning and in various phases of Bright's disease of the kidneys we have symptoms indicating Digitalis. Retention of urine; dribbling of urine. Spermatorrhea, Nightly emission. In persons addicted for years to secret vices. Enlarged prostate gland.

It is capable of curing chronic gonorrhoea. It has cured acute gonorrhea. It has cured inflammation of that thin, delicate membrane covering the glans penis. Dropsical swelling of the genitals.

Food: "Loss of appetite and violent thirst." Most doctors give Sulphur when the patient drinks much and eats little. The nausea of Digitalis is not like that of Ipecac. and Bryonia. It is a singular nausea. The smell of food excites a deathly nausea, a sinking, a goneness, associated with cardiac troubles, with Jaundice and liver troubles.

The nausea is accompanied by a deathly feeling, as if be is sinking away. Sometimes the nausea is relieved by eating, but the sinking remains after eating, showing that it is something besides hunger.

"Persistent nausea.

Extreme sensitiveness, in the pit of the stomach. Faintness and sinking in the pit of the stomach as if be would die.

No appetite, but great thirst.

Soreness and hardness in the region of the liver. Sensitiveness to pressure in the region of the liver."

Now remember the liver and the heart symptoms, the jaundice, the slow pulse, the awful sinking in the stomach, the enlargement of the prostate gland, the gray stool, and you have the principal symptoms of Digitalis.

After all that I have said you are not surprised at the horrible anxiety that the Digitalis patient carries with him all the time.

He wants to be alone; sadness, melancholy, despondency and restlessness. He canít decide upon anything that be ought to do; tremulousness.

The stomach, bowel and liver troubles are just what you see sometimes in a hard drinker after trying to break off. He is prostrated; his heart gives out, is irregular, weak, slow; and he has sadness and melancholy; inability to apply himself. Digitalis will help him straighten out.