American Materia Medica, Therapeutics and Pharmacognosy

sudden cessation of the heart in systole. Respiration ceases last. It
exercises an irritating influence directly on the muscle fibers of the
heart. lts action on the heart is the same as that of muscarine. It does not
act on the vaso-constrictors.
Under physiological conditions, the diuretic action is uncertain. Under
pathological conditions, it renders the pulse less frequent, more vigorous
and more regular; it promotes diuresis, causes the disappearance of
dropsical swellings, and improves the subjective condition of the patient.
Unlike the most of the heart remedies, the effects of strophanthus seem to
be caused by the agent being brought into direct contact with the
muscular structure of the heart itself, after absorption into the blood.
There is excellent authority for the belief that it neither acts through the
medulla nor through the inherent ganglionic heart centers. It acts, by
contact. It causes violent contraction of the heart muscle in extreme
cases, being the only one of the heart poisons to leave the heart in systole
after death from its use. It does not influence the vascular system.
The diuretic influence of the agent, if observed, is quite permanent. It
increases the blood pressure in the kidneys to a great degree through its
influence on the heart muscles, and thus directly upon the capillary
circulation. It is also direct in its action upon the secreting and
excreting mechanism of the kidney; by this influence its diuretic action
is explained.
Specific Symptomatology—The direct indications for this agent are a
weak and rapid heart from muscular weakness, inactivity or lack of
contractile power. Apparently strophanthus acts similarly to digitalis, but
it is not a cumulative poison. Pius, of Vienna, says in disturbances of
compensation, strophanthus acts well. The pulse becomes stronger and
diminishes in frequency, respiration becomes normal and dyspnea less
marked.
Therapy—In rapid and feeble heart strophanthus reduces the pulse and
increases the power. In some cases it also reduces the temperature.
Dyspnea is relieved in a few minutes after its administration, and the
pulse becomes stronger and more regular in less than an hour. Its
influence is exceedingly persistent and can be depended upon
sometimes for weeks after the agent is discontinued.
Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 417