Curse of the foxglove and other stories . . .

The curse of the foxglove began in 1785, and its latest manifestation can be found in the current European Heart Journal, where two papers have reached diametrically opposite conclusions about the use of digoxin in atrial fibrillation, with and without heart failure (2013, doi:10.1093/eurheartj/ehs348, doi:10.1093/eurheartj/eht120). The use of digitalis was famously first described by William Withering, the Birmingham physician and member of the Lunar Society, but his precedence was hotly challenged by a fellow Lunar man, Erasmus Darwin, who practised in nearby Lichfield. They had previously had friendly discussions about the right amount of foxglove to put in tinctures for the dropsical. Now they were at each other’s throats, with accusations of plagiarism, dangerous practice, and patient stealing. Thank goodness that cardiology has moved on since those dark times.

“It could give me two heads, and I’d still try it!” is the arresting subtitle of a qualitative study of patient experiences, attitudes, and expectations about the information they receive before starting anti-tumour necrosis factor treatment for rheumatoid arthritis (BMC Musculoskeletal Disorders 2013;14:165, doi:10.1186/1471-2474-14-165). Most of …