Quinina, Quinine. The alkaloid, the bisulphate, the hydrobromide, the hydrochlorate, the salicylate, and the sulphate are official in average doses of 4 gr. For local use the alkaloid is to be preferred. Subcutaneously, the bisulphate is most reliable as a rule, and its ready solubility makes its internal use ofttimes preferable to the sulphate. Its 0.2% solution is used as a douche in coryza. The salicylate is markedly antiseptic. The official oleate (25%) is well adapted for inunctions.

In large doses (6 to 20 gr.) quinine is so important a drug that space precludes any adequate presentation in a small volume like this. It is antipyretic, antiperiodic, antiseptic, and emmenagogue; employed to reduce fever in typhoid, pneumonia, and other states; to destroy the malarial parasite in the many forms of malarial fever: as an antiseptic in the intestinal canal; and in amenorrhea and to hasten labor as an emmenagogue.

Since the plasmodium malariae is destroyed in solutions of I part of quinine to 20,000 of water, the excessive doses formerly used do not seem necessary. Moderate doses, given during the intermission, are effective, and do not so disturb the nervous system. In continued types of fever it is best to give quinine when the temperature is at its lowest point or the secretions the most active. Quinine always acts best when the skin and tongue is moist and the pulse soft and open. Phenacetin is a valuable agent to promote these conditions and prepare the system for quinine. Where there is no remission in fevers, quinine should be employed cautiously, if at all, but once the fever subsides quinine is highly necessary. In intermittents, I like broken doses of the sulphate in the intermission. In congestive chill, we want full doses with stimulants and local heat. As an antipyretic, quinine is less used than formerly, but cannot be entirely shoved aside. Probably we have given too large doses. In amenorrhea, it is best to give a warm bath and follow with good doses. In labor, 10 or 15 gr. of the bisulphate at one single dose is indicated in uterine inertia, and the lack of nervous force upon the part of the patient.

In small doses (2 gr.) it is a valuable bitter tonic, the bisulphate being preferable to the sulphate. It may be used in many conditions, but is commonly employed in convalescence from pneumonia and other debilitating disease, especially where there has been sepsis, prostrating discharges, or nervous debility. In states of debility in chronic disease with night sweats or congestive visceral states marked by atonicity, it is quite useful alone or combined with other indicated drugs. Quite adequate doses of quinine can be administered to infants by inunction.

In minute doses (1-10 gr. or Ix trituration) quinine has a certain range of utility in cases marked by periodicity and spinal sensitiveness.

Headache of malarial origin, neuralgia relieved by pressure, the aching sensitiveness along spine and back of the neck, and subacute facial neuralgias are ofttimes much relieved by these small doses if frequently repeated. The homceopathic Chininum arsenicosum, or arsenite of quinine, in the 2X, is an excellent tonic, markedly benefiting persons inclined to neuralgia and where there is a sense of weariness and prostration. In uncomplicated diarrhea it is effective. The IX is full dosing. but can be carefully employed in obstinate intermittents.