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In a dramatic scene in the film Casino Royale, James Bond’s martini is poisoned. His high-tech MI6 equipment tells us it is digitalis, which comes from the foxglove plant. After going into cardiac arrest he is brought back to life with a defibrillator and returns to the poker table to (naturally) win the game. Although foxglove can be deadly, it has saved many more lives than it has cost, because of this very effect on the heart. In this chapter we explore the effects of digitalis, the use of its main alkaloid digoxin in modern-day medicine to treat heart problems, and the havoc it wreaks on the heart if too much is taken. Digoxin is one of many similar cardiac glycosides, and we will uncover a problem with a common preliminary forensic toxicology test, which cannot tell the plant apart from a venomous toad.

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