Strophanthine's forgotten history

Sit back and get comfortable. Today, I want to tell you a story—not about a new drug, not about a cutting-edge therapy. But about something that has been completely and unjustly forgotten. About strophanthin.

I know the name might sound unfamiliar. But this substance was, quite literally, a lifesaver for hearts for decades.

What was strophanthin?

Strophanthin (g-strophanthin, also known as ouabain) is a cardiac glycoside that once played an important role in the treatment of heart diseases. Contrary to what some might think today, it wasn’t some primitive remedy from the pre-modern medicine era. It was a solid, well-researched substance. Effective. Safe—when used correctly.

A History Written in Quiet Words

Let’s start from the beginning.

In the mid-19th century, it was discovered that the Strophanthus plant contains substances with a powerful effect on the heart. Was it a coincidence? In a way, yes. One of the English botanists, Kirk, noticed a rapid effect on the heart after coming into contact with a powdered seed.

Soon after, Scottish pharmacologist Thomas Fraser developed the first preparation — "Tinctura Strophanthia". And so began the story of treating the heart with strophanthin.

Injections, drops, tablets

In 1904, a purified form—g-strophanthin (ouabain)—was introduced, produced by E. Merck and Boehringer Mannheim. Intravenous forms of the drug acted quickly and were widely used—also in oral formulations.

In the 1930s, Dr. Edens demonstrated that strophanthin was effective in treating angina and heart attacks. At the time, he said: “The day will come when the failure to administer strophanthin in time will be considered a medical error.”

He wasn’t alone.

In Germany and France, doctors widely used ouabain. Various forms of administration were developed: intravenous, oral, and sublingual. One particularly popular preparation was *Strophoral*. Others included "Purostrophan" and "Strophoperm" — with better absorption, fewer side effects, and lower required doses.

And then — silence fell

In the 1970s, something happened that today would be called a negative media campaign and political smear. After the so-called "Heidelberg Tribunal" — a public denunciation of ouabain supporters — the drug began to fall out of favor. It was accused of being toxic (due to its narrow therapeutic index) and ineffective. But was this justified? Not necessarily.

The pharmaceutical industry shifted its focus to digitalis — preparations derived from foxglove. These were popular, backed by large companies and better suited to the “modern” pharmaceutical marketing model.

Bioavailability? A Weak Argument

Strophanthin was criticized for its supposedly low oral bioavailability (2–15%). But no one mentioned that digitalis also requires individualized dosing. As you know—not everyone responds to the same dose. And doctors had known for decades: “every heart needs its own dose of strophanthin.”

What’s more, the data on oral bioavailability—on which nearly every physician bases their critical view of this substance—may very well originate from flawed scientific studies. You’ll read about this, as well as other research indicating a much higher absorption rate than commonly assumed, in the following article: What is the truth about ouabain bioavailability?

Why did it really disappear?

Not because of side effects. Not because of lack of effectiveness.

What was lacking — and still is — were the funds for costly double-blind clinical trials required for re-registering the drug. These trials remain the gold standard of medical research and the foundation of Evidence-Based Medicine. Small companies couldn’t compete with the pharmaceutical giants offering beta-blockers and ACE inhibitors. Strophanthin didn’t fit — and still doesn’t seem to fit — into the prevailing medical dogma and power structures.

What do we lose?

Strophanthin worked differently than digitalis. More subtly, more gently. It acted faster, but it didn’t accumulate in the body as easily. It also showed lower toxicity, fewer interactions, and — as research has shown — a significant impact on calcium regulation and cellular metabolism.

But the most important part? Its effect on the heart wasn’t just mechanical. It transmitted signals. It regulated cell proliferation, apoptosis, and metabolism. Today, we know that the Na⁺/K⁺-ATPase is not just a pump — it’s also a signal transducer. And ouabain is its natural ligand.

Yes — the body produces it on its own. We've known this for over 30 years. It has been found in the adrenal glands, pituitary gland, and hypothalamus. Endogenous strophanthin. No one questions that anymore.

Will ouabain come back?

It’s hard to say. There are either no companies capable of meeting today’s strict regulatory requirements, or only a handful. And those that could — don’t want to risk the marketing “black legend” surrounding it. A systematically designed and constructed vicious cycle that serves the few at the expense of the many.

That’s exactly why I’m telling you this—so it won’t be forgotten.

What can you do about it?

I’m not trying to convince you of anything. Well — maybe just this one thing: share this text wherever you can.

I quietly hope that if you ever hear about strophanthin or ouabain again—you won’t just shrug it off. You’ll ask. You’ll think. Maybe in a few years, it will return as a “new breakthrough drug.” And yet, it’s just the same old, trusted strophanthin- a remedy worth saving from being forgotten.

Quotes from Doctors – What Did They Say About Strophanthin?

Original text and referenced sources:

• Fürstenwerth, H. (2014). The lost part of the ouabain story. ResearchGate. [source text]
• Fraser, T. R. (1885). The action and uses of digitalis and its substitutes, with special reference to strophanthus hispidus. British Medical Journal.
• Kern, B. (1974). Der Myokardinfarkt (3rd ed.). Haug Verlag.
• Edens, E. (1948). Die Digitalisbehandlung (3rd ed.). Urban & Schwarzenberg.
• Samolewitz, E. (1921). Klinische Erfahrungen mit Purostrophan. Medizinische Klinik.
• Bellon, E. (1922). L’action toni-cardiaque des comprimés d’Ouabaine [Thèse de doctorat en médecine]. Université de Paris.
• Boehringer Mannheim. (1952). Für und wider die orale Strophanthin-Therapie (Studienreihe Boehringer).
• Erdle, H.-P., Schultz, K.-D., Wetzel, E., & Gross, F. (1979). Resorption und Ausscheidung von g-Strophanthin. Deutsche Medizinische Wochenschrift, 104, 976–979.
• Marchetti, G. V., et al. (n.d.). [Farmakokinetyka ouabain].
• Kern, B. (1951). Die orale Strophanthin-Behandlung. Selbstverlag.
• Heidelberger Tribunal (1971). Sprawozdanie publiczne.
• Christophersen, H. (n.d.). Der Schlüssel zur Infarktverhütung. [Wydawnictwo prywatne].

Disclaimer:
The content of this article is intended solely for informational and educational purposes. Its aim is to raise awareness about the discussed substance, not to promote any specific product. The information presented is based on available sources and scientific research and does not constitute medical advice. It should not be interpreted as an encouragement to self-diagnose or treat any health conditions. In case of any health concerns or doubts, it is strongly recommended to consult a physician or another qualified healthcare professional.