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The decline in cardiac output following the administration of digitalis to experimental animals (1-5) and to normal human subjects (6-10) would appear to be inconsistent with the well known positive inotropic action of this drug. The latter has been further confirmed by direct measurement of myocardial contractile force in both man and dog in the absence of heart failure ( 5, 11, 12). Peripheral pooling of blood leading to a decreased return of venous blood to the heart has been suggested by several investigators as a possible explanation for this phenomenon (13-15). Tainter and Dock (16) observed an increase in portal venous pressure following digitalis administration in the dog and postulated that hepatic vein constriction resulted in pooling of blood in the splanchnic bed. It is now clear that digitalis glycosides act directly on the peripheral circulation of both dog and man (12, 17). To define further the peripheral actions of these drugs, a preparation was developed which permitted characterization of the effects of digitalis on the capacity of the peripheral vascular bed and on venous return.

STUDIES ON DIGITALIS. II. EXTRACARDIAC EFFECTS ON VENOUS RETURN AND ON THE CAPACITY OF THE PERIPHERAL VASCULAR BED