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JAMA 100 Years Ago
August 24/31, 2011

THE USE AND ABUSE OF DIGITALIS IN DISEASES OF THE HEART

JAMA. 2011;306(8):887. doi:10.1001/jama.2011.1138

R. ABRAHAMS, M.D., NEW YORK

Since William Withering, a Birmingham practitioner, gave his “Account of Foxglove” in 1785, digitalis has been the favorite remedy in diseases of the heart. The great popularity of the drug, however, rendered it subject to abuse as well as to use. It suffered all through these many years and decades and still suffers to-day from misappliance and insufficient appliance in the very dominion it rules. For example, if precordial pain, palpitation or a murmur is made the basis for prescribing digitalis it is a misapplication of a valuable agent constituting a serious abuse. Or, if digitalis is ordered merely because the patient has “heart disease,” the drug, no less than the patient, is grievously abused. Another form of abuse of digitalis, even though the condition of the heart calls for it, is the withdrawal or discontinuance of the drug as soon as its therapeutic effects become manifest. Let it be distinctly understood that a diseased heart which has shown failure of compensation once or twice should be kept under the beneficent influence of digitalis as long as it keeps on beating, which means indefinitely.

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