page_title: Digitalis
section_title: Toxicity
hierarchical_section_title: Digitalis / Toxicity
caption_attribution_description: Deutsch: Roter Fingerhut. A B Pflanze in natürl. Grösse; 1 Blüthe im Längsschnitt, wenig vergrössert; 2 Staubgefäss, vergrössert; 3 und 4 dieselbe geöffnet, desgl.; 5 Pollen, desgl.; 6 Stempel, desgl.; 7 Griffel mit Narbe, desgl.; 8 Fruchtknoten im Längsschnitt, desgl.; 9 derselbe im Querschnitt, desgl.; 10 Frucht nat. Grösse; 11 Same, vergrössert; 12, 13 derselbe zerschnitten, desgl. English: Digitalis purpurea, Drawing depicting Digitalis purpurea, from en:Franz Eugen Köhler's Medizinal-Pflantzen. Published and copyrighted by Gera-Untermhaus, FE Köhler in en:1887 (en:1883–en:1914). The drawing is signed W. Müller. Source [1]. Latina: Digitalis purpurea. Русский: Наперстянка пурпурная. A, B — растение; 1 — цветок в продольном разрезе; 2 — тычинка; 3 и 4 — то же со вскрывшимся пыльником; 5 — пыльца; 6 — пестик; 7 — столбик с рыльцем; 8 — завязь в продольном разрезе; 9 — то же в поперечном разрезе; 10 — плод (коробочка); 11 — семя; 12, 13 — то же в разрезе.
context_page_description: Digitalis is a genus of about 20 species of herbaceous perennials, shrubs, and biennials commonly called foxgloves.
  This genus was traditionally placed in the figwort family Scrophulariaceae, but recent phylogenetic research has placed it in the much enlarged family Plantaginaceae. This genus is native to western and southwestern Europe, western and central Asia and northwestern Africa. The flowers are produced on a tall spike, are tubular, and vary in colour with species, from purple to pink, white, and yellow. The scientific name means "finger-like" and refers to the ease with which a flower can be fitted over a human fingertip.
  The best-known species is the common foxglove, Digitalis purpurea. This biennial plant is often grown as an ornamental plant due to its vivid flowers which range in colour from various purple tints through pink, and purely white. The flowers can also possess various marks and spottings. Other garden-worthy species include D. ferruginea, D. grandiflora, D. lutea and D. parviflora.
  The term digitalis is also used for drug preparations that contain cardiac glycosides, particularly one called digoxin, extracted from various plants of this genus.
context_section_description: Digitalis toxicity (also known as digitalis intoxication and digitalism) results from an overdose of digitalis and causes nausea, vomiting and diarrhea, as well as sometimes resulting in xanthopsia (jaundiced or yellow vision) and the appearance of blurred outlines (halos), drooling, abnormal heart rate, cardiac arrhythmias, weakness, collapse, dilated pupils, tremors, seizures, and even death. Bradycardia also occurs. Because a frequent side effect of digitalis is reduction of appetite, some individuals have used the drug as a weight-loss aid.
  Digitalis is an example of a drug derived from a plant that was formerly used by folklorists and herbalists; herbalists have largely abandoned its use because of its narrow therapeutic index and the difficulty of determining the amount of active drug in herbal preparations. Once the usefulness of digitalis in regulating the human pulse was understood, it was employed for a variety of purposes, including the treatment of epilepsy and other seizure disorders, which are now considered to be inappropriate treatments.
  Depending on the species, the digitalis plant may contain several deadly physiological and chemically related cardiac and steroidal glycosides. Thus, the digitalis plants have earned several, more sinister, names: dead man's bells and witch's gloves.
  The entire plant is toxic (including the roots and seeds). Mortality is rare, but case reports do exist. Most plant exposures occur in children younger than six years and are usually unintentional and without associated significant toxicity. More serious toxicity occurs with intentional ingestion by adolescents and adults. Early symptoms of ingestion include nausea, vomiting, diarrhea, abdominal pain, wild hallucinations, delirium, and severe headache. Depending on the severity of the toxicosis, the victim may later suffer irregular and slow pulse, tremors, various cerebral disturbances, especially of a visual nature (unusual colour visions (see xanthopsia) with objects appearing yellowish to green, and blue halos around lights), convulsions, and deadly disturbances of the heart. For a case description, see the paper by Lacassie. Vincent van Gogh's "Yellow Period" may have been influenced by digitalis therapy which, at the time, was thought to control seizures. As noted above, other oculotoxic effects of digitalis include generalized blurry vision, as well as seeing a "halo" around each point of light.
  In some instances, people have confused digitalis with the relatively harmless comfrey (Symphytum) plant, which is often brewed into a tea, with fatal consequences. Other fatal accidents involve children drinking the water in a vase containing digitalis plants. Drying does not reduce the toxicity of the plant. The plant is toxic to animals, including all classes of livestock and poultry, as well as felines and canines.
  Digitalis poisoning can cause heart block and either bradycardia (decreased heart rate) or tachycardia (increased heart rate), depending on the dose and the condition of one's heart. Notably, the electric cardioversion (to "shock" the heart) is generally not indicated in ventricular fibrillation in digitalis toxicity, as it can increase the dysrhythmia. Furthermore, the classic drug of choice for ventricular fibrillation in emergency setting, amiodarone, can worsen the dysrhythmia caused by digitalis, therefore, the second-choice drug lidocaine is more commonly used.
caption: Digitalis purpurea drawings by Franz Köhler
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