DIGITALIS:
A NEW USE
FOR THE OLD
VENERABLE
HEART
MEDICATION
Morris Weiss, MD
O
nce upon a time in 1775, Mother
Hutton, a little old lady in Shrop-
shire on the left band of the languid
Severn River and in the shadow of the stately
ruins of Roman Wroxeter, had a secret family
recipe for the cure of dropsy administered
after the more regular physician had failed.
William Withering, who was born in Shropshire, a young, hand-
some and energetic physician to the General Hospital in Birming-
ham, learned her (Mother Hutton's) tea contained 20 herbs. After
arriving in his horse-drawn carriage and learning of the contents,
this educated English gentleman physician and world renowned
botanist felt Foxglove was the only herb in her concoction that
was of medical value. Foxglove (Digitalis Purpura) is a ubiquitous
English garden flowering plant.
Withering made a preparation of the leaves and flowers and
described the benefit of relieving dropsy (peripheral edema). His
patients received various concentrations of his herbal tea. His classic
monograph described the benefits and deleterious side effects, most
commonly nausea and vomiting.
To this day, 300 years later, his observations have no peer. He
showed digitalis relieved edema in patients with large hearts but
little to no effect in those with shrunken kidneys. He also describes
slowing of the pulse in those with rapid irregular heartbeats (possibly
atrial fibrillation) and all this with simply taking a history, bedside
observation and using his fingers to examine the pulse.
But why waste time on a bit of cardiology history most of this
Journals’ readers memorized in sophomore pharmacology?
MARCH 2017
11