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Reputation of Digitalis

Reputation of Digitalis

Digitalis Purpurea – the Foxglove: An Appreciation

“Most species [of Foxglove] are perennial, which is a convenience, and they have other merits, but none has the presence or force of Digitalis Purpurea. Its habitant in the wild are varied. We associate it with woodland but seed lies dormant for many years until the wood is coppiced, or until large gaps are created by a storm, and light is at last admitted.” Country Life, 1990[1]

Harold Bloom’s famous essay, the Anxiety of Influence, describes the idea of the strong poet. The poet who does not suffer from the crippling fear of the influence of those who came before. What the strong poet writes comes to occupy a special place in the human imagination. The place occupied by some poets and not others is mirrored in the way some things occupy our imaginations more strongly than others. The strongest poets echo, quote, reflect and, in their lack of fear, they transcend the past. They write words so the interplay between creator and created is made clear. But things that come to occupy a place in our minds are not creators but subjects. They can have no anxiety, but they have plenty of influence. So, why one thing and not another.

Some plants and flowers are stronger in the human imagination than others. They are complex in the associations that they create in us. They transcend other plants by carrying us to many places at once. The poppy. The rose. The tulip and daffodil. Each takes our imagination on a particular journey when we read, hear, see or smell them. The poppy is heroin and the First World War. The rose is both the thorn and true love. The commodification and the romanticism of the tulip and the daffodil are as one. These associations are a densely tangled cacophony of memory, quotation, school recital, time and place.

While we do not want or need to make a league table, my candidate for the strongest of the strong flowers, is none of these. For me, that which makes the most densely packed set of associations and contradictions in the human imagination, a cousin of hemlock in impact, an associate of penicillin in medicinal capacity and the sister of the rose in beauty, albeit an unusual and quirky kind, is the foxglove. Digitalis.

But the question is why?

Let us begin with the name. The Foxglove is said to have appeared in a list of plants from the time of Edward III. But is first described by Fuchsius. After the success of his Method of Curing Syphilis (Metodus curandi morbi Gallici), Remaclus Fuchsius of Limburg published his nomenclature of plants in 1542.  Fuchsius is also known as Fuchs which means Fox in German and the colour fuchsia, the colour of digitalis purpurea,  is named after him. Fushsius gave the flower its scientific name, commenting that up to this time there was no accepted name for the plant in Latin or Greek. Digitalis is “in allusion to the German name of Fingerhut, which signifies a finger-stall, from the blossoms resembling the finger of a glove.” We know this because William Withering tells us in his An Account of the Foxglove and Some of its Medical Uses with Practical Remarks on Dropsy, and other Diseases, published in 1785. We will return to wonderfully named William Withering later, but his christening of the Foxglove opens up the whole world of etymology, the origins of names. The origins ascribed by Fuchsius were extended by the pioneering photographer, William Fox Talbot, who had a side line in etymology. He published his English Etymologies in 1847. He tells us that in Welsh the Foxglove is called maneg ellyllon, or fairies glove. It is also Ffyon. In the London library edition of this book, in spidery pencil lines, someone has written, “in Ireland fairy thimble”.

Digitalis, Floxglove.

Fox Talbot speculates in a wonderfully Victorian way that “in the days of our ancestors, as everyone knows, these little elves were called in English, “the good folks.” No doubt then, these flowers were called “the good folks’ gloves,” a name since shortened into foxgloves, because it was believed that if you used the names of fairies you would attract their attention. Indeed, if a Foxglove bends towards you as you walk by it is not the wind. The Fairies have recognised you as a kindred spirit.  In contrast, he tells us, the Greeks called it the “trumpet flower”. One hundred and ninety pages later, Fox Talbot, returns to the theme and tells us that they are also known as “Witches Thimbles”. The Fairies have been replaced by witches, the good folk, by the bad. Perhaps. But witches are also interchangeable at times with wise old women and these in turn were often midwives. Foxglove was used in child birth if contractions were not progressing quickly enough. This led to an association with Venus and in turn to the Virgin Mary. As usual with digitalis good and bad are bound together in beauty.

In 1863, R.C.A. Prior entered the fray with his On the popular names of British plants.  Using the Norwegian name, Revbieldle, fox-bell, as his evidence, he tells us that the original name was Foxes-glew or music. Later, he also tells us that they were also called Lady’s Fingers. They do, in fact look like mittens and bells.

They also often grow around foxes’ lairs or foxes make their lairs around the places that they grow. And they are poisonous. So, tales began that foxes would wear them as mittens to cover the sound of their approach. Witches would use them in brews to kill their enemies. Fairies would wear them as gloves because of the wonderful colours. And bees are provided with a landing platform from which to collect pollen by the bell-shaped petals. There are many names for fox gloves involving bees.

These myriad tales and origins weave together. Thimbles, mittens, gloves, fingers, witches, foxes, bells, bees. Withering. Fox Talbot. Fuchs/Fox. A plant that can grow as tall as a human and can kill that human or help it be born. With colours that can enchant, tempt you in. The source for John Wyndham’s classic The Day of the Triffids. The story of plants that nearly destroy humanity. The abiding human fear of extinction. Perhaps?

This is the second layer of their place in our imagination.

According to Walter Sneader’s, Drug Discovery, the Myddvai a family of 13th century Welsh healers used the foxglove to relieve “headache, abscesses and cancerous growths.” It had been well known as a folk cure for centuries. It was not until 1775 that it began to be brought into systematic use, though for much of the 19th century in the wrong way, with highly variable and often fatal results.

William Withering was one of the richest physicians outside London. He learned of the use of Foxglove when he was asked, in 1775, to give his opinion of a cure long kept secret by an old women in Shropshire who “sometimes made cures after the more regular practitioners had failed”. Impressed he tried Foxglove on 163 of his poorer patients, recording each case. “It would have been an easy task to have given select cases, whose successful treatment would have spoken in favour of the medicine…But Truth and Science would condemn the procedure. I have therefore mentioned every case in which I have prescribed the Foxglove.” Many were cured, at least for a time. Many others died.  Much of Withering’s book is concerned with the way in which the foxglove allowed patients to produce a large amount urine. In 1799, Ferriar showed that the increase in urine was not as important as the power of foxglove to increase and regularise the pulse rate. The pharmacologist Ludwig Traube then proved the stimulating effects of the foxglove on heart muscles in 1850. It was only after 1901 when the heart could be accurately measured using polygraphs and electrocardiographs that the real use of digitalis in atrial fibrillation could be fully established. Digitalis is a natural form of steroid, used to strength the heart beat during heart failure. Withering was the Michele Ferrari, of day, but before steroids were called steroids. He had no idea what he was doing, using a process of trial and error. I suspect Ferrari was the same.

Once its use was established as a stimulate and before the polygraph, there were many attempts to define the right dosage for the desired effect. The French Societe’ de Pharmacie offered a prize of 500 francs in 1820, this had to doubled after five years when no one claimed it. Finally, in 1841, the French pharmacists E. Homolle and Theodore Quevenne won “the award for their isolation of an impure crystalline material which consisted mainly of impure digitoxin”. As Sneader outlines:

They called this ‘digitalin’, a name also applied to various products obtained by other workers. Digitoxin, the principal cardiotonic glycoside present in the leaves of Digitalis purpurea, was isolated in 1875 by Schmiedeberg at the University of Strassburg…The structure of digitoxigenin was determined by Walter Jacobs and his colleagues at the Rockefeller Institute in New York, but it was not until 1962 that chemists at Sandoz in Basle elucidated the structure of the sugar residue and hence that of the entire molecule of digitoxin…In the late 1920s, it was discovered that the powdered leaves of Digitalis lanata, once popularly known as ‘woolly foxglove’, had greater physiological activity than those of Digitalis purpurea. This led Sydney Smith of Burroughs Wellcome in London to isolate digoxin. This is now used more than either powdered digitalis leaves or digitoxin since it does not bind as strongly to proteins in the tissues and plasma, resulting in less delay before a therapeutic concentration of unbound drug can build up.

There is a huge global pharmaceutical market for the product. It is on the World Health Organisation essential drug list. It was the drug used in most of Charles Cullen’s  29 murders during his time as a nurse. As always with the Foxglove, where there is light there is also darkness. 

On its way to becoming a tool of big Pharm, the foxglove paused to be the key ingredient in a popular 19th century cigarette called the Crevoisier and to make appearances in the work of at least three of the greatest poets in the English language: Tennyson, Wordsworth and Yeats – but did it also influence the use of yellow in the work of Van Gogh?

Sadly the idea that Van Gogh was poisoned by the prescription of Digitalis was comprehensively refuted by Anna Gruener in the Journal of General Practice back in 2013. The idea was that digitalis brought on xanthopsia which influenced the use of yellow. Dr Gruener demonstrated that this was not the case, not least because his doctor, Dr Gachet, was “Well aware of the potential lethal side effects of the drug, he used homeopathic doses and wrote in an unpublished treatise: ‘We understand the physiologic effects of this plant well enough today to be afraid of its dangers, and strongly advise against its use, since it can produce syncope by slowing the heartbeat and it can cause paralysis of that organ.’

But feel the strength of the idea that it could have been digitalis. The Guardian was still running a story in August 2017 which repeated all the old ideas and ends by simply saying it is all speculation! It is as though the journalist wanted the Foxglove to have this power because it connects with the third element in the Foxglove’s strength. The creative. That the greatest artist of the 19th century, the most beautiful colourist perhaps of all time, was actually influenced in his work and perhaps even killed by something as beautiful and strange as the Foxglove, is irresistible.

Wordsworth wrote the The Borderers, in 1785. It is described as his first major work. He was obviously not so sure. He sensibly put it away until 1842 when he decided he had better publish it rather than leave it for his heirs to decide what to do with it. It is a gothic tragedy. The plot need not worry us too much but the foxglove appears when woman describes a dream she had:

[A female Beggar rises up, rubbing her eyes as if in sleep–a

Child in her arms.]

BEGGAR. Oh! Gentlemen, I thank you;

I’ve had the saddest dream that ever troubled

The heart of living creature.–My poor Babe

Was crying, as I thought, crying for bread

When I had none to give him; whereupon,

I put a slip of foxglove in his hand,

Which pleased him so, that he was hushed at once:

When, into one of those same spotted bells

A bee came darting, which the Child with joy

Imprisoned there, and held it to his ear,

And suddenly grew black, as he would die.

MARMADUKE. We have no time for this, my babbling Gossip;

Here’s what will comfort you.

[Gives her money.]

BEGGAR. The Saints reward you

For this good deed!–Well, Sirs, this passed away;

And afterwards I fancied, a strange dog,

Trotting alone along the beaten road,

Came to my child as by my side he slept

And, fondling, licked his face, then on a sudden

Snapped fierce to make a morsel of his head:

But here he is, [kissing the Child] it must have been a dream.

OSWALD. When next inclined to sleep, take my advice,

And put your head, good Woman, under cover.

BEGGAR. Oh, sir, you would not talk thus, if you knew

What life is this of ours, how sleep will master

The weary-worn.–You gentlefolk have got

Warm chambers to your wish. I’d rather be

A stone than what I am.–But two nights gone,

The darkness overtook me–wind and rain

Beat hard upon my head–and yet I saw

A glow-worm, through the covert of the furze,

Shine calmly as if nothing ailed the sky:

At which I half accused the God in Heaven.–

You must forgive me.

OSWALD. Ay, and if you think

The Fairies are to blame, and you should chide

Your favourite saint–no matter–this good day

Has made amends.

BEGGAR. Thanks to you both; but, O sir!

How would you like to travel on whole hours

As I have done, my eyes upon the ground,

Expecting still, I knew not how, to find

A piece of money glittering through the dust.

Wordsworth was clearly aware of the foxglove in a number of different dimensions – as medicine, as the bell of folklore and the connection with fairies. Alfred Lord Tennyson, selects the Foxglove to appear in the 83rd part of In Memorium, in a selection of flowers which together make a sad bunch with the Foxglove giving the spire, the architectural centre of the group:

In Memorium

LXXXIII.

Dip down upon the northern shore,

O sweet new-year delaying long ;

Thou doest expectant nature wrong ;

Delaying long, delay no more.

What stays thee from the clouded noons,

Thy sweetness from its proper place ?

Can trouble live with April days,

Or sadness in the summer moons ?

Bring orchis, bring the foxglove spire,

The little speedwell’s darling blue,

Deep tulips dash’d with fiery dew,

Laburnums, dropping-wells of fire.

O thou, new-year, delaying long,

Delayest the sorrow in my blood,

That longs to burst a frozen bud

And flood a fresher throat with song

The Two Voices in Tennyson’s bleak poem, which he called in Manuscript form “The Thoughts of a Suicide”, are emotion and reason. The argument is about the suicide of Tennyson’s close friend, Arthur Hallam, and the work emerged from a prolonged period of depression.

“Yet,” said the secret voice, “some time,
Sooner or later, will gray prime
Make thy grass hoar with early rime.

“Not less swift souls that yearn for light,
Rapt after heaven’s starry flight,
Would sweep the tracts of day and night.

“Not less the bee would range her cells,
The furzy prickle fire the dells,
The foxglove cluster dappled bells.”

It is striking that in the midst of the consideration of the value of the individual human life and the futility of it, Tennyson turns to the foxglove cluster and its dappled bells to say if you die the world will go on, the grass will grow, the sun will rise, the bee will buzz. Perhaps too also alluding to the way in which the foxglove seed can lay dormant until the light finds it.

W.B. Yeats was given Digitalis from 1936 onwards, (there is a hint in the Yeats Journey that it might have contributed to his death),  and repeated stories of the Foxglove in his Celtic Twilight: “A few miles eastward of Lough Gill, a young Protestant girl, who was both pretty herself and prettily dressed in blue and white, wandered up among those mountain mushrooms, and I have a letter of hers telling how she met a troop of children, and became a portion of their dream. When they first saw her they threw themselves face down in a bed of rushes, as if in a great fear; but after a little other children came about them, and they got up and followed her almost bravely. She noticed their fear, and presently stood still and held out her arms. A little girl threw herself into them with the cry, “Ah, you are the Virgin out o’ the picture!” “No,” said another, coming near also, “she is a sky faery, for she has the colour of the sky.” “No,” said a third, “she is the faery out of the foxglove grown big.” The other children, however, would have it that she was indeed the Virgin, for she wore the Virgin’s colours. Her good Protestant heart was greatly troubled, and she got the children to sit down about her, and tried to explain who she was, but they would have none of her explanation. Finding explanation of no avail, she asked had they ever heard of Christ? “Yes,” said one; “but we do not like Him, for He would kill us if it were not for the Virgin.” “Tell Him to be good to me,” whispered another into her ear. “We would not let me near Him, for dad says I am a divil,” burst out a third.”

There are many other instances of the Foxglove in literature. Richard Buchanan published a tragedy called Foxglove Manor in 1885, there is a journal of poetry and fiction called the Foxglove Journal and the inspiration poetry web site lists 21 poems about foxgloves. The epigram for this essay is from a Country Life gardening column and there is a huge amount of gardening writing about the culturation, harvesting and appreciation of the many varieties of foxlove across the main gardening journals, magazine, websites and books.

And so in the end there is simply the aesthetic. Foxgloves have the best kind of beauty, the unconventional kind. They lack perfect symmetry, their interiors are speckled with dots  -to help the bees land perhaps, their bell shape makes them awkward, unwieldy, they are not petit, demure, they have real bodies, organized chaotic symmetries and an unorthodox relationship to colour and shape. You cannot plant them in neat rows because they sway, the fairies seeing a kindred spirit, and break the boundaries of your ornamental beds. In 1757 Edmund Burke published his Philosophical Enquiry into the Origin of our Ideas of the Sublime and Beautiful. He argued that terror was “the ruling principle of the sublime” and “The passion caused by the great and sublime in nature . . . is Astonishment; and astonishment is that state of the soul, in which all its motions are suspended, with some degree of horror. In this case the mind is so entirely filled with its object, that it cannot entertain any other.” It is beyond the beautiful because of the terror at the magnitude of the event that comes to occupy the whole of the mind. Or if we claim a little less, it is the terror behind the beauty that moves the object to the sublime. In each dimension of that which makes the Foxglove a “strong” flower we see the binary of the beautiful and the deadly. There are few things that fulfil the full meaning of the word as Digitalis. This is the last source of is strength. Digitalis is beautiful, it is deadly, it is sublime.


[1] Christopher Lloyd, Fox gloves Impress: In his Garden, Country Life, London: Vol 184, Iss. 51 (Dec 20 1990): 90

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