Digitalis purpurea

Common name
i) Fox-glove.
ii) Finger hut.
iii) Gant de notre dame.
Introduction
A plant common throughout Europe growing best on siliceous soils in thickest
bushy grounds and waste places.
The root is biennial or perennial from which in the second year ascends a single
erect leafy stem from two to five feet high.
The flowers are numerous in a long simple spike.
The fresh leaves from the uncultivated plant in its second season are gathered
when about to bloom and from them the tincture is made.
Syn. - Digitalis Purpura.
Fox glove.
Fairy fingers- N. O. - Scrophulariaceae.
Prover: Dr. Hahnemann.
Drug totality
D = Debility: feels as if dying extreme prostration.
I = Irregular Intermittent pulse: intermitting every third fifth or seventh beat.
G = Goneness sensation in the stomach.
I = If moves heart would stop.
T = Talking fatigue: great weakness of chest.
A = After coitus weakness of genitals.
L = Lips lids: blueness of skin with distended veins.
I = Internal and external dropsy.
S = Stool: light ash-coloured chalkly white.
Physiological action
I. Heart - Musculo-motor stimulation irregular firm-contraction.
II. Arteries - Vaso-motor stimulant; firm arterial-contraction.
III. Vagi - Paralysis to terminal twig. emesis congestion.
IV. Kidneys - Increased blood pressure diuresis
V. Stomach and Colon - Congestion inflammation.
VI. Liver - Portal congestion Jaundice salivation.
VII. Sex - Organs - Stimulation profound prostration.
VIII. Brain - Congestion delirium coma.
IX. Eyes - Mydriasis chromatopsia inflammed.
X. Cord - Complete loss of reflex function paralysis.
XI. Temperature - Greatly lowered.
General features
1. Weakness
i) Exhaustion extreme prostration; feels as if he were dying.
ii) Great weakness of chest can not bear to talk.
iii) The fingers "go to sleep frequently and easily.
II. Motion aggravates
i) Sensation as if heart would stop beating if she moved
ii) Fatal syncope may occur when being raised to up-right position.
Peculiar features
i) Sensation as if heart would stop beating if she moved.
ii) Faintness or sinking at the stomach.
iii) Pulse: intermitting every third fifth or seventh beat.
iv) The fingers "go to sleep" frequently and easily.
Cardiovascular system
a) Clinical
i) Angina pectoris (Ref. Clarke).
ii) Cyanosis: due to slow pulse.
(Ref. Farrington. ).
iii) Acute and sub-acute inflammation of the heart.
iv) Weak heart
Without valvular complications.
b) Causation
i) Sexual excess.
(Ref. Clarke).
ii) High living.
iii) Alcohol.
(Ref. Clarke).
c) Sensation
i) Thinks if he moves heart would stop.
ii) Goneness in the region of stomach which ameliorated by eating.
(Ref. Farrington).
iii) Heart stand still with great anxiety.
vi) Weakness: Heart.
Forearm.
(Ref. Clarke).
Note: -Dr. Farrington reports there is a sensation of goneness in the region of
stomach which amel by eating.
But master kent says it is not ameliorated by eating.
d) Pain
i) Digitalis has got stitches in the region of the heart coming on at every 15
minutes lasting for 5-6 seconds each time.
(Ref. Clarke).
e) Pulse
i) Master Kent classically explains the Digitalis has numerous heart symptoms but
none is so important as the slow pulse.
ii) The pulse is slow in the beginning may now be flying like lightning.
iii) The patient himself seldom knows but some one says that in the beginning the
pulse was 48 that is Digitalis (Ref. Kent).
iv) The Digitalis pulse is at first slow and perhaps remain so for many days (Ref.
Kent).
untill finally the heart commence to go to quiver with a irregular beat intermits
feels as if it would cease to beat (Ref. Kent).
v) Master Kent says.
Weakness is a very characteristic of Digitalis pulse.
It may have violent pulse but not rapid pulse - sudden violent beating of the
heart with disturbed rythm.
vi) In a patient pulse is very slow
pulse flutters and increases in its action
Now patient turns over in bed.
Now it seems as if the heart would stop.
If he moves he feels fluttering all over him.
vii) Dr. Alien says pulse full irregular very slow and weak; intermitting every 3rd
5th or 7th beat.
viii) Dr. Clarke says very slow pulse on rising up in bed pulse become much more
frequent and irregular.
ix) Dr. Farrington explains through the irritation of pneumogastric nerve
inhibition of the hearts action
Pulse slow
Arterial tension is greatly increased
Due to action on the vaso motor centre at die base of the brain.
There fore pulse is primarily slow and strong.
x) Again affects Muscular Tissue
There by causes weakness of cardiac tissues
Weakness of the pulse.
xi) Dr. Farrington suggests pulse is slow often slower than the beating of the
heart and irregular both in rythm and in volume.
Note
i) If the pulse in the beginning-rapid don't think of Digitalis for it will not do any
good.
ii) Dr. N. M. Chowdhury says Digitalis is a cardiac regulator.
It's action upon the heart is dual in nature.
iii) Effect on cardiac ganglia and muscles
Induces contract
Strengthen the systole
Increase arterial tension (Ref. N. M. Chowdhury)
iii) Action on vagi
Prolongs diastole
Diastole lengthen more blood allowed to enter the ventricle (Ref. N. M.
Chowdhury)
f) Palpitation
i) Palpitation originating from grief.
(Ref. Kent)
ii) Palpitation aggravates by slight ascend each movement of body.
(Ref. Clarke)
iii) Dr. Farrington refers sometimes palpitation without suitable cause.
b) Concomitant with palpitation
i) Cold sweat.
(Ref. Clarke)
ii) Uneasiness in heart with constant pain.
iii) Sinking sensation.
iv) Purple face (Ref. Clarke)
c) Modality
a) Aggravation on changing position especially when rising from the horizontal
(Ref. Clarke)
ii) Heaviness and weakness of left arm fingers go to sleep easily cold limbs
cyanosis.
(Ref. Clarke)
Modalities
I) Aggravation
i) When sitting Esp. when sitting erect.
(Ref. Lippe)
ii) Lying on leftside.
iii) Sexual excess.
iv) After meals.
v) From motion.
(Ref. Clarke)
vi) By exercise.
vii) Mental emotion.
viii) From music.
ix) From mental exertion.
x) From pressure.
xi) Fatal syncope may occur when being raised to upright position.
II. Amelioration
i) By lying on back.
ii) From rest.
iii) Open air.
h) Concomitant and associated features
i) Nothing is more important than weakness As if dying.
ii) Cardiac dropsy with suppressed urine (Ref. Farrington).
iii) Distended veins in lips lids ears etc.
iv) Sensation of coldness of skin.
(Ref. Farrington)
v) Oedema - hydropericardium hydrothorax ascites oedema of scrotum and penis
anasarca (Ref. Farrington)
vi) Enlarged liver with Jaundice and pale stool (Ref. Kent)
vii) Fingers go to sleep frequently and easily.
viii) Face pale death like appearance and bluish red blueness of the skin eyelids
lips tongue --} Cyanosis.
ix) Anxious restless with horrible dreams and sinking in the stomach (Ref. Kent).
x) Flushes of heat followed by nervous weakness.
xi) Exhaustion extreme prostration.
Explanation with illustrative cases
i) Digitalis acts on the base of brain
Depresses the pulse rate.
Slow pulse
Then affects the muscular tissue
weak heart.
ii) Sometimes weakness of heart is so great that heart can not transmit the
impulse to radial pulse.
(Ref. Farrington).
iii) Dr. N. M. Chowdhury says affects the cardiac ganglion and muscles
Strengthens the systole
iv) Affects the vagi
lengthens the diastole --}cardiac regulator.
(Ref. N. M. Chowdhury).
Dropsy
Causation
i) Post-scarlatinal.
ii) In Bright's disease.
iii) From alcohol.
iv) Of cardiac origin (Ref. N. M. Chowdhury)
Location
i) Dropsy affecting the internal and external parts.
ii) Swelling of the feet; nocturnal swelling of fingers.
(Ref. Boericke)
iii) Shining white swelling of joints.
iv) Sensation in legs as if a red hot wire suddenly darted through them.
Features
1. Cyanosis
i) Face pale death like appearance and bluish-red.
ii) Blueness of skin eyelids lips tongue.
iii) Distended veins on lids ears lips and tongue.
II. Respiration
i) Respiration irregular difficult deep sighing.
ii) Fatal syncope may occur when being raised to up right position.
III. Weakness
i) Great weakness of chest cannot bear to talk.
ii) Exhaustion: extreme prostration; feels as if he were dying.
iii) The fingers "go to sleep" frequently and easily.
IV. Urine
i) Suppression of urine.
ii) Urine is deep-coloured brownish or reddish.
(Ref. Clarke).
iii) Continuous urging in drops dark hot burning.
iv) Sharp cutting or throbbing pain at neck of bladder as if a straw was being
thrust back and forth; worse at night.
v) Constriction and burning as if urethra is too small.
Modalities
I. Aggravation
i) when sitting especially when sitting erect.
ii) Motion.
II. Amelioration
i) In open air.
c) Concomitant and associated features
i) Pulse full irregular very slow and weak intermitting every third fifth or seventh
beat.
ii) Sensation as if heart would stop beating if she moved.
iii) Faintness or sinking at the stomach.
iv) Enlarged sore painful liver.
v) Stools very light ash -coloured delayed chalky white pipe stem stool and
involuntary.
vi) One hand and foot icy-cold and other warm
General modalities
i) Aggravation
When sitting especially when sitting - erect from motion; after meals; from music;
from exertion; from lying on left side; and from sexual excess.
ii) Amelioration
From lying on back; in the open air. when the stomach is empty; and from rest.
Relations
i) Antidotes
Nux. V; op; sweet milk with foenum graecu; vegetable acids vinegar infusion of
galls ether camphor keep patient recumbent and give alcohol Tannin has been
recommended in order to precipitate Digitalin in the stomach, antidote to wine
and to the jaundice caused thereby, myr, cer.
ii) Compatible
Bell Bry cham cinch Lyc. Nux. V op Phos puls Sep Sul Ver.
iii) Inimical
cinch Nitr. Sp. d.
iv) Similar
Alkaloids which have similar action such as adonidin antiarir convalamarin,
Helleborein, neriin, olendrin, scilliain, Acon, Antt, Bry, Camph, Lyc, Natrm. M, Nux.
V, Phos, Puls, Spig, Sul, Tabac, Ver.