The Pharmacology of the Cardiac Glycosides

  • Theodore M. Brody
  • Tai Akera
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 34)


The term digitalis encompasses a wide variety of steroids which have the property of increasing the force of contraction and eliciting characteristic electrophysiologic effects upon the heart. These substances are derived from a number of plant and animal sources. The medicinal actions of the squill, or sea onion, were recognized as early as 1600 B.C. Digitalis-like activity is present in the seeds of strophanthus gratus, which is the source of ouabain, used as an African arrow poison and in the skin of the toad, used by ancient Chinese herbalists. The glycosides most frequently used today are derived from the leaves of the foxglove, Digitalis purpurea and D. lanata. The classic study on the action of digitalis was published in 1785 by William Withering who described his long experience with digitalis in An Account of the Foxglove, and Some of Its Medicinal Uses: With Practical Remarks on Dropsy, and other Diseases {1}. Withering failed to recognize that its efficacy in reducing edema was secondary to its cardiac action. A second comprehensive monograph was published in 1799 by John Ferrier, who suggested that digitalis might have a cardiac effect distinct from its ability to promote a diuresis. Traube in 1850 also recognized the effect of digitalis in promoting the efficiency of cardiac muscle and further suggested that the bradycardia was the result of vagal stimulation.


Atrial Flutter Cardiac Glycoside Positive Inotropic Effect Sodium Pump Purkinje Fiber 
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© Springer Science+Business Media Dordrecht 1984

Authors and Affiliations

  • Theodore M. Brody
  • Tai Akera

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