INAUGURAL dissertation 
ON THE USE OF 
DIGITALIS PURPUREA, 
OR 
PURPLE FOXGLOVE, 
IN THE CURE OF DISEASES. 
SUBMITTED TO THE PUBLIC EXAMINATION OF THE 
UNDER THE AUTHORITY OF THE 
TRUSTEES OF COLUMBIA COLLEGE, 
FACULTY OF PHYSIC 
IN THE 
STATE OF TIBET- YORK; 
The Right Rev. BENJAMIN MOORE, D.D. President; 
FOR THE DEGREE OF 
DOCTOR OF PHYSIC\ 
ON THE 4th OF MAY, 1802. 
JACOB V. BROWER, A.M. 
OF NEW-VORK. 
Printed by T. & J. Swords, Printers to the Faculty of Physic 
of Columbia College. 
NEPF-YORK: 
1802. AN 
INAUGURAL DISSERTATION 
ON 
DIGITALIS PURPUREA. 
Of the Digitalis Purpurea, or Purple Foxglove. 
The Digitalis Purpurea is placed by Lin- 
naeus in the class of didynarnia, and order of 
angiospermia. 
Botanical Description. 
The foxglove grows to the height of four 
.or five feet, with an erect and tapering stalk. 
The leaves are large, hairy, oblong, and 
pointed. Their colour is a dark diisky green, 
approximating to brown. The leaves exhale 
a strong odour, something similar to tdbacco, 
and have a bitter and nauseous taste ';' but are 
Uot so acrid and pungent as many other veget- 4 
ables which are administered in larger doses 
with perfect safety. The nauseous and bitter 
qualities of the leaves can be imparted to 
watery and spirituous menstrua. 
The floral leaves or bracteas are spear- 
shaped, and purplish towards their points. 
The calyx consists of five eliptical segments. 
The flowers are monopetalous, and of a pur- 
ple colour: they have some resemblance to 
the finger of a glove, whence the name di- 
gitalis, or foxglove, originates. 
The foxglove grows in India, is found in 
many parts of Europe, and has been culti- 
vated in this country. It grows wild in woods 
when left to nature, and flowers in June, July, 
or August. The digitalis is a biennial plant, 
which arrives at its full growth and native 
perfection only in gravelly soils, where there 
is present little or none of the calcareous 
earth. 
Of the growth and method of curing the 
Foxglove. 
By consulting writers upon the natural his- 
tory of this vegetable, we find that barren. gravelly, or sandy soils, and hedges and such 
situations as are considerably elevated, are 
the only places in which it flourishes and ar- 
rives at its fullest maturity. Botanical authors 
relate that it delights in shade and in deep 
hedge-rows, and that sheltered ground is the 
favourite situation of foxglove. 
This vegetable has lately been cultivated 
in the suburbs of this city, and does not 
appear to degenerate. It grows to its usual 
height, anchputs on the appearance of health 
and vigour. 
Some plants arrive at the highest perfection 
in their original wild state, in woods, and 
among shrubs and bushes. But this is not the 
case with all herbs, and probably it is not the 
case with digitalis. The foxglove which re- 
ceived its growth here has been put to the 
test of experiment. It has been administered 
in tincture and in substance. No peculiarity 
or defect is observed in its operations on the 
human body. The effects produced are 
similar to those which the imported foxglove 
usually produces: 
The general employment of digitalis has 
excited much attention with respect to the 6 
method of collecting and curing the leaves, 
and the mode of preparing them for use. 
When the leaves of foxglove are gathered 
for the purpose of preserving them a number 
of years, they should be collected from 
healthy, vigorous plants, growing on hills, 
in an unmanured soil, and in situations 
which are most exposed to the rays of the sun. 
Such plants as have acquired a darkish and 
brownish colour are preferable to others. 
After the leaves are collected they are care- 
fully separated from the stalks, and the latter 
cut away, so as only to leave room to tye them 
into small bunches, which are hung in a warm 
and airy apartment. This apartment has a 
current of air passing through it, and the 
rays of the sun excluded. 
The leaves, when dry, are partially pow- 
dered; by which operation the stalks and 
fibrous parts are almost completely separated. 
The finer part of the leaves, when sufficiently 
pulverized, is bottled and closely corked, to 
prevent the admittance of air, for future 
use. 
Another method of preserving this valuable 
medicine, not inferior to the one already 7 
mentioned, is the following After dividing 
the leaves into several pieces, compress them 
into a tight and convenient box or canister* 
Keeping them close in this state, and in a dry 
situation, they will preserve their virtues un* 
impaired formany years. 
With respect to the time of gathering the 
green leaves. Dr. Withering directs that they 
be gathered “ about the time the flowering 
stem has shot up, and when the blossoms are 
coming forth.” However, from repeated 
trials it is found that if they be collected late 
in summer, or even in autumn, provided they 
receive no injury from cold or frost, their 
virtues arc probably augmented, and their 
medicinal qualities certainly not impaired. 
Different preparations. 1. The substance. 2. 
The decoction. 3. The infusion. 4. The 
tincture. 
1. The most simple method of administer- 
ing the foxglove is in powder, or in the form 
of pills. Half a grain, or one grain of the 
substance, is a sufficient quantity for a patient 
to begin with. The pulverized seeds are, on 8 
many accounts, preferable to the leaves. 
“ In them the whole virtues of the plant are 
concentrated.” 
c 2. There are many persons of peculiar ha- 
bits of body, who are incapable of taking- 
medicine in the form of pills. They almost 
immediately induce in them nausea and vo- 
miting. In such cases liquid medicines are 
preferable: they can generally be retained in 
the stomach with great facility. A decoction 
of the digitalis, made according to the fol- 
lowing formula, is exhibited with much ad- 
vantage:^—On two drams of the dried leaves 
of foxglove pour two quarts and a pint of 
water, and boil down the contents to two 
quarts. Half an ounce of this can be taken 
two, three or four times a day. 
3. A slight decoction is injurious to many 
plants not more volatile than digitalis: a 
lengthy and violent decoction will certainly 
dissipate the virtues of this valuable article 
of the materia medica. Dr. Withering and 
others consequently preferred the infusion. 
The method of preparing it, as Dr. Wither- 
ing directs, is as follows:—Let one dram of 
the dried leaves be infused for lour hours in 9 
half a pint of boiling water; add to the 
strained liquor half an ounce of any spirituous 
water: an ounce of this to be given twice a 
day to an adult. 
For the purpose of bringing the system 
gradually under the influence of digitalis* 
the following is, perhaps, the most judicious 
formula:—On one dram of the powdered 
leaves pour a quart of boiling water, and let 
it stand for forty-eight hours. 
One ounce of the dried leaves is equal to 
four of the green, for the purpose of either 
decoction or tincture* 
4. The Tincture. 
Another mode of exhibiting foxglove is by 
making a saturated tincture. Dr. Darwin 
gives it the preference, and lays down the 
following rule:—“ Put two ounces of purple 
foxglove, digitalis purpurea, nicely dried and 
coarsely powdered, into a mixture of four 
ounces of rectified spirit of wine and four 
ounces of water; let the mixture stand by the 
fire-side twenty-four hours, frequently shak- 
ing the bottle, and thus making a saturated 10 
tincture of digitalis; which must be poured 
from the sediment and passed through filtering 
paper. Thirty drops of this tincture is di- 
rected to be put into an ounce of mint water 
for a draught to be taken twice or thrice a 
day, till it reduces the anasarca of the limbs, 
or removes the difficulty of breathing in hy- 
drothorax, or till it induces sickness.” 
The object of this preparation is to impart 
as much of the active parts of the leaf as the 
spirit is capable of taking up and retaining in 
solution. If digestion be continued a week 
or more, a very important object is gained; 
half the quantity of leaf being sufficient, and 
a larger quantity of the tincture of equal effi- 
cacy is procured. If the digestion be con- 
ducted in a cool temperature, it is less liable 
to variation: it becomes more uniform and 
permanent in different temperatures. The fol- 
lowing formula, agreeable to the above direc- 
tions, is a very valuable one, and has been 
proposed as a standard for universal use. 
Recipe, 
Folior. digit, purpur. recent, exsiccat unc. 
Sps. vin. unc. viii. M. 
Bigere leni calore per dies septem. Or—Recipe, 
Folior. digit, purpur. recent, unc. iL 
Sps. vin. rect. unc. v. M. 
Digere dies septem leni calore. 
Mode of Exhibition. 
Physicians differ in opinion respecting the 
method of exhibiting the digitalis purpurea. 
Some prefer its substance in powder or in pill; 
others declare that its virtues are extracted, 
and that it operates with much greater effi- 
cacy ill decoction or in tincture. 
It is said that the powder more speedily 
nauseates, and more readily increases the dis- 
charge from the kidneys or intestines; and, 
therefore that it is not so serviceable in pul- 
monic complaints. As the principal object, 
by exhibiting this medicine, is to diminish 
vascular action; and as this end can be ac- 
complished by either the tincture or the 
powder, any disputation about which of these 
two ought to be employed is unnecessary. 
Perhaps it is agreeable to truth and matter of 
fact to state, that there is no difference in the 
effect produced on the system by different pre- parations of this remedy, provided the dose be 
in all cases exactly the same. 
It is not possible at all times to determine 
with precision the exact quantity of digitalis 
contained in a given quantity of liquid. At 
the time of preparing a decoction or infusion, 
many accidents and circumstances may occur 
to render it doubtful how much of the ac- 
tive virtues of the plant may be present in a 
given dose. 
It is a desideratum in medicine to have a 
preparation which may serve as a general 
standard, possessing its virtues unimpaired at 
all times and in all places. A saturated tinc- 
ture can best answer this intention. 
That sensible organ the stomach, through 
the agency of which the action of medicines 
is conveyed throughout the body, in a great 
degree, becomes insensible to their operations, 
after it has been accustomed to them for some 
time. An augmentation of the dose becomes 
necessary to produce the same effect. Very 
irritable stomachs are unable to retain a full 
dose of digitalis. This observation holds good 
with respect to many other active remedies, 
such as opium, cicuta, the squills, and hyr 13 
drargyrum: hence the necessity and advan- 
tage of gradually augmenting the dose of 
active remedies in the treatment of obstinate 
chronic diseases. 
The following method, if adhered to, is 
found to be a valuable practical rule:—Begin 
with adults in doses of ten drops of the tine.- 
ture, or half a grain of the powder, or one 
table spoonful of either the decoction or in- 
fusion, repeated three times a day; gradually 
enlarging the dose, if no disagreeable symp- 
toms ensue, as the exigency of the case may 
require. If nausea, vertigo, or great irregu- 
larity of pulse supervene, the doses must be 
diminished, or totally omitted for a time. In 
children the medicine should be lessened in 
quantity in proportion to their ages. By this 
manner of exhibition the weakest constitu- 
tion and the most irritable habit of body may 
be sufficiently charged with the influence of 
the purple foxglove. 
Modus operandi. 
Some physicians imagine that the good ef- 
fects of foxglove result from its power of di- 14 
minishing secretion and promoting absorp- 
tion. But it may be objected in reply, that 
foxglove proves very serviceable in cases 
where there is no increase of pus or mucus, as, 
for instance, in dry coughs and dyspnoea. 
Digitalis does not always prove effectual by 
reducing the frequency of the pulse: several 
instances have been remarked where the pul- 
sations appeared to be somewhat increased, 
and yet a complete cure effected. 
The manner in which digitalis operates is 
explained by Dr. Darwin in the following 
words:—“ From the great stimulus of this 
medicine the stomach is rendered torpid with 
consequent sickness, which continues for 
many hours and even days, owing to the 
great exhaustion of its sensorial power of ir- 
ritation : and the action of the heart and arte- 
ries becomes feeble from the deficient excite- 
ment of the sensorial power of association: 
and, lastly, the absorbents of the cellular mem- 
brane act more violently in consequence of 
the accumulation of the sensorial power of 
association of the torpid heart and arteries.” 
When a small quantity of foxglove is at first 
taken, and the dose gradually augmented. the patient feels the following effects and 
changes.—Torpor and heaviness of the whole 
body, languor and indifference to voluntary 
exertion, slight nausea, vertigo, pain and a 
sense of lightness in the head: then, if the 
medicine be persisted in, comes on extreme 
nausea and vomiting; objects appear of a 
green colour. If the urine be sensibly in- 
creased in quantity, these symptoms are not 
so violent, or a longer space of time is required 
to produce the same effects. 
The pulse becomes affected in a remark- 
able manner; the heart and arteries beat less 
frequent, or with great irregularity; while 
feeling the pulse of a patient, it sometimes 
appears as if the action of the heart was for a 
moment suspended; general irritation is al- 
layed; the actions of the absorbent vessels are 
increased; the lymphatics are placed in a 
state of carrying on healthy absorption, and 
continue so till they regain their former habit 
of action. 
If forty drops of the tincture, or two grains 
of the substance of digitalis, be thrown into 
some irritable stomachs, it will speedily pro- 
duce nausea and vomiting, which evinces 16 
tlie propriety of beginning with small dosesy 
as already mentioned, and of making a gra- 
dual increase, that the stomach may be ha- 
bituated to their operation. By these precau- 
tions the effects of foxglove are observed be- 
fore they become excessive. 
The reduction of vascular action without 
inducing previous excitement, is peculiar to 
the digitalis purpurea* 
Correctors of the deleterious effects of Digitalis, 
As digitalis diminishes the power and acth* 
vity of the arterial system, it is of importance 
that some substance should be given with it, 
which, while it permits the digitalis to pro- 
duce this effect, might also prevent that ex- 
treme languor which often proceeds so far as 
to sink the patient. Some physicians have 
thought thatSeneka snake-root will frequently 
serve this purpose; and that calomel, com- 
bined with the powder of digitalis, is also a 
corrector of it. Steel will also aid the system 
in such cases; for if wine and the more dif- 
fusible stimuli, or the tonics joined with 
much aroma, should be given, then too much 17 
excitement would be produced after the ex- 
citability had been accumulated by the torpor 
and languor produced by the digitalis. Steel, 
we know, is a pure tonic, and only produces 
stimulant effects in a moderate manner: 
whenever, therefore, the stomach is first af- 
fected, the nausea will be carried off by the 
suspension of the and the admini- 
stration of porter or some bitters. When the 
pulse is affected the stomach seldom partakes; 
and then the pulse may be raised by giving 
some steel, or tincture of bark, although the 
digitalis be persisted in. If vertigo be pro* 
duced, the foxglove must absolutely be de- 
sisted from; and then steel and the warm bath 
are the proper correctives. 
Diseases in which Digitalis proves of benefiti 
1. In inflammatory diseases attended with 
local congestion. 2. In consumption. 3. In 
dropsy. 
1. In the first class of diseases, the foxglove 
is serviceable upon the principle of its operat- 
ing quickly and powerfully upon the arterial 
system, and thereby arresting the rapid pro- gress of the inflammatory Croup/ 
pleurisy, peripneumonia, chronic cough, ca- 
tarrh, mania, and hooping-cough, are cured 
hy the use of digitalis. 
Case of chronic cough. 
A. L. aged 38, has been troubled for eigh- 
teen months past with a continued cough. At 
present breathes with difficulty: voice hoarse; 
coughs violently at times; expectorates mu- 
cus; sleeps ill for the most part; pulse 96, 
full and strong. 
December 28th. Took half a grain of di- 
gitalis, and the same quantity of opium made 
into a pill, three times a day. 
30th. Pulse nearly the same; sleeps rather 
better; bowels costive. Took five grains of ca- 
lomel with each pill until a stool was procured. 
January Ist. Is better in every respect; 
urine increased in quantity. The digitalis is 
increased to one grain. 
Sd. Coughs more; pulse 90; complains of 
weakness in the joints. The pills are omitted, 
and half a grain of digitalis and one grain of 
opium are taken morning and evening. 19 
sth. Is better in every respect; pulse 8b; 
expectorates less. 
7th, 9th, 11th, 14th, 18th. Gets better; 
pulse slow; urine increased in quantity. 
20th. Complains of debility. Was put on 
the use of tonic medicines, and has since 
recovered. 
2. Consumption. The foxglove was for- 
merly used with advantage in epilepsy, and 
in scrophula, taken either internally, or ap- 
plied externally in the form of ointment. It 
has long since been recommended for con- 
sumption also; but from want of knowledge 
of its properties, and mode of exhibition, it 
was employed with such caution that the sick 
were left without relief and without hope. 
In phthisis the foxglove acts on the system 
and corrects its morbid phenomena, by pro- 
ducing absorption—allaying the cough and 
the augmented irritation of the lungs—and 
diminishing the action of the heart and ar- 
teries. 
Case.—Deborah G—•, aged 18, of a delicate 
habit of body, upon making an excursion 
into the country was taken with chills, suc- 
ceeded by hot fits, slight cough, impaired appetite, and a stoppage of the menstrual dis- 
charge. No medical aid being applied for 
four months, the symptoms increased in vio- 
lence, and daily grew more alarming. 
November Bth. Coughs and expectorates 
considerably; sleeps little; has pain in the left 
side, and difficulty of deglutition; exacerba- 
tions of fever morning and evening, and col- 
liquative sweats. Took of the tincture of di- 
gitalis ten drops three times a day. 
9th, 10th, 11th. No sensible effect pro- 
duced by the digitalis; pulse 88. 
12th. Urine increased; cough and expec- 
toration as before. 
13th. The tincture increased to twelve 
drops, 
14th. Expectorates less. Digitalis taken 
four times a day, 
15th. Is delirious at times; expectorates lit- 
tle; coughs more. Medicine omitted. 
18th, 19th. Cough less; sleep and appetite 
better; expectorates freely. 
In phthisis pulmonalis it has been observed 
in the New-York hospital, that it was an un~ 
favourable symptom when digitalis did not 
lessen the frequency of the pulse; and in such 21 
eases the patient generally showed after death 
tubercles in the lungs. 
3. Dropsy. The indications of cure in this 
complaint are, Ist. To evacuate the supera- 
bundant fluid: 2d. To prevent its farther 
accumulation. To obviate the first indication 
active diuretics are employed, in order to 
stimulate the kidneys and determine the serous 
fluid to those passages. 
From sympathy, or an indissoluble associ- 
ation between the heart and stomach, if nau-r 
sea be produced, the pulse sinks in conse- 
quence. As arterial action is diminished 
absorption begins: hence the use of emetics 
to produce absorption. By means of the 
digitalis absorption can be produced from the 
lungs, abdomen, &c. without the disagree- 
able intervention of nausea and vomiting- 
O 
This remedy is found to be most serviceable 
in the following species of dropsy: Ascites, 
anasarca of the lungs, hydrops pericardii, 
hydrops thoracis. 22 
Case of Ascites, 
James H , shipcarpenter, of strong 
muscular fibre and plethoric habit, having 
exposed himself, in the month of September, 
to much rain and a chilly night air, was at- 
tacked with fever, which was subdued by the 
usual remedies. A few days after apparent 
recovery he again exposed himself to a very 
damp and cool atmosphere. 
October 2d. Complains of pain in the head 
and abdomen; ordered a dose of calomel. 
4th. Pain in the head better; urine scanty, 
6th. Has a sense of weight, fullness, and 
tightness of the abdomen; great thirst; a fluc- 
tuation in the abdomen perceptible. 
7 th. Took twelve drops of the tincture of 
digitalis morning and evening. 
Bth. No sensible change. 
Pth. Much as before. Took twelve drops 
three times a day. 
10th, Urine increased in quantity; the dose 
augmented to fifteen drops. 
11th, 12th. No pain; respiration free. 
14th. The abdomen is of its natural size. 23 
RECAPITULATION. 
1. Digitalis, if carefully and gradually ex- 
hibited, may ultimately be given with perfect 
safety in large doses. 
2. When digitalis is exhibited repeatedly* 
and at short intervals, the strictest caution is 
necessary to prevent the alarming and even 
fatal consequences which may ensue. 
3. When the system becomes charged, and 
completely under the influence of digitalis, 
it possesses a power of arresting the motion 
of the heart and arteries to a degree hitherto 
thought incompatible with the existence of 
animal life. 
4. Digitalis, in simple inflammatory dis- 
eases, may supersede the necessity of repeated 
bleeding and purging. 
5. Digitalis is an excellent remedy in ana- 
sarcous affections of the lungs, and in cases 
where effusion or inflammatory exudation has 
taken place. 
6. The foxglove is a glorious remedy in 
active haemorrhage, by retarding the velocity 
of the circulation. 24 
1. In pulmonary consumption, arising 
from haemoptysis, much relief is obtained 
from the use of digitalis. . 
8. Digitalis is useful in chronic coughs- in 
spasmodic asthma, and in palpitations of the 
heart not depending on debility, upon the 
principle of diminishing irritability. 
9. The criterions by which we are to be. 
guided in regulating the doses of foxglove, 
are the phenomena arising from its action on 
the stomach, on the sensorium, and on the 
blood-vessels. 
FINIS.