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Digitalisは医薬として記載された当初(Withering 1785)は利尿薬と考えられていた。その後心臓に対する作用が詳細に研究されるに及んで心臓作用が強調される様になつた。そしてCushny1)の記載以来,Digitalisはその強心作用によつて循環障害を取除く結果として利尿を起すという解釈が支配的になり,この考が薬理学上の定説となつた。Digitalisの主成分又は混在成分の腎臓に対する直接作用についても多くの研究がなされ,一部の薬理学者はこの二次的利尿説に疑義を抱いたが,併し多くの実験結果はこの説に合う様に解釈され時にはかなり無理なコジ付けがなされた。併し,腎臓の生理薬理や水分電解質代謝に関する知識が進むにつれて,強心配糖体の利尿作用が昔考えられた程単純なものでない事がわかつて来た。以下主に近年の成績を基礎にしてこの問題を眺めて見よう。
The mechanism of the diuretic action of cardiac glycosides was discussed in this review article on the basis of recent literatures and data obtained by the author and his collaborators. Ouabain injected into the left renal artery produced a continuing marked increase in urinary excretion as well as sodium excretion from the left kidney while urinary output was unchanged or decreased in the right kidney. It was proved by direct method with bubble flow meter and by clearance test that blood flow decreased only in the left kidney in which ouabain had been injected. It was noted that the increase in potassium excretion was not closely related to diuresis produced by ouabain, since it was not so marked or negative in dogs as in rats which showed a constant increase in potassium excretion by ouabain.
The author concluded that ouabain inhibits the reabsorption of sodium in renal tubule and produces diuresis with no direct connection with the action on the heart.
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