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March 16, 1963

Initial and Maintenance Digitalization-Reply

Author Affiliations

San Francisco

JAMA. 1963;183(11):977. doi:10.1001/jama.1963.03700110108027

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To the Editor:  —Dr. Silber writes that it has been his practice routinely to redigitalize, in 3 or 4 days, those patients who received rapid initial digitalization in the hospital. He states, however, that "When this technique is employed, the incidence of side effects is no greater than when initial digitalization is carried out by conventional methods with oral long-acting glycosides alone." Surely, it must be the aim of the clinician to plan a digitalis-therapy regimen which has the greatest likelihood of avoidance of these potentially serious side effects. Every thoughtful physician knows that the problems of congestive heart failure are not usually solved permanently by a single hospital admission no matter how careful or precise a regimen is planned and recommended. It is pointed out in my study that all such management must be individualized for maximum benefit, and the results obtained were not projected by me into the

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