Quinia Sulphas. (Quinine.)
There is no occasion to give a lengthy description of the specific action of Quinine, as every one of my readers is thoroughly conversant with it. But it may be of use to some, to state the conditions necessary to its kindly and medicinal action.
Probably there is no remedy in the Materia Medica that gives so many failures as this, and I think we may be safe in assuming that it is given ten times where its specific action is obtained once. Every one will recollect cases in which it did not break up periodic disease, many more cases in which its influence was but temporary, a large number in which it produced unpleasant cerebral symptoms, and some in which a Quinia disease was developed, which was much worse than the original malady.
Why is this? Is it the fault of the remedy, the fault of the patient, or the fault of the practitioner? 0, the doctor answers, it is from idiosyncrasy! So we believe, but we locate the idiosyncrasy in the doctor's head, and not in the patient.
I have taught for years, that if we are to expect the kindly and curative action of Quinia, the stomach must be in condition to receive and absorb it, and the system in condition for its action. If we have a proper condition in these respects, we will hear nothing of roaring in the ears, vertigo, etc., but its action will be most kindly. The rule is very simple—Given, a soft and open pulse, a moist skin, moist and cleaning tongue, and Quinia will act kindly, antidote the malarial poison, or in small doses improve innervation. Always get this condition before prescribing the remedy, and you will never be disappointed in its action.
As an antiperiodic I believe in prescribing single doses. Put the stomach in proper condition, regulate the circulation, establish secretion, and then give one full dose of the remedy, (10 to 15 grs.) The best form of the remedy is in solution with one or two ounces of water, using a sufficient quantity of sulphuric acid.
This is not only the most certain method of administration, but I think it will be found the most pleasant.
It is hardly necessary to impress upon the reader the necessity of determining the periodic element in disease. Whilst we may not know what it is, or how Quinine antidotes it, we know that its removal cures, or at least paves the way to a cure.
But Quinine is not specific to all agues. We see it given day after day, week after week, in many cases, without any advantage. But on the contrary, it excites the nervous and vascular systems, and at last produces a chronic erythism of them, that is correctly named "the Quinine disease." From this, recovery is far more difficult than from the malarial affection.
Is it possible then, to determine the cases in which Quinine will prove specific, and the cases in which it will fail ? I think it is. It antidotes the malarial poison only when kindly received and absorbed, and when the system is in such condition that it can be readily excreted. Given, the condition of pulse, skin and tongue, that we have already named, and its action is as certain as could be desired.
In some cases, the general treatment directed to obtaining normal activity of the various functions, is the most successful. In some cases Nux Vomica or Strychnia is preferable. In others minute doses of Arsenic antagonizes the malarial poison. Whilst in some rare cases, I have treated the disease most successfully with Aconite and Belladonna.
As a stimulant to the cerebro-spinal centers, its use is very important. In many forms of disease, especially in the advanced stages, we find an impaired innervation, preventing functional activity, or its restoration and continuance by the use of remedies. It is essential to success that innervation be increased, not temporarily by the use of stimulants, but somewhat permanently. This we accomplish by the administration of small doses of Quinine (grs. ½ to grs. ij). Even here, we find it necessary to observe the rules for its administration already noticed—the patient must be prepared for its use.
It favorably influences the nutrition of the nerve centres, and hence is employed in the treatment of chronic disease with enfeebled innervation, with marked advantage. There are two classes of chronic disease in which it is useful—the one in which there is a malarial influence, with obscure periodicity, and the other the enfeebled innervation, as named above.
Its general tonic and stomachic influence, (when obtained) is most certainly from this action upon the nervous system—the influence extending to the sympathetic ganglia, as well as to the cerebro-spinal centers. In some cases this action is very important, improving digestion and blood-making, and nutrition, as well as waste and excretion—aiding "the renewal of life."