Abstract
Digitalis purpurea (foxglove) has been used for centuries. It was among the herbal remedies used in ancient Rome, and in the 16th century it was used in Ireland, Germany and England for ‘dropsy’ and other medical conditions. In 1785, William Withering reported on his study of digitalis extract used in 163 hospitalized patients, concluding that its beneficial action was due to effects on the power and motion of the heart. Pure digitoxin was first isolated from foxglove in 1875, and digoxin, the glycoside used today, was first isolated in 1957.1 Evidence to guide optimal management of heart failure continues to evolve, however, and the role of digitalis in heart failure has been called “the oldest continuing controversy in the history of medicine.”2 The articles in this selection provide food for thought on the place of digoxin in modern evidence-based management of heart failure.
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