Dose of any of the barks. - 15 gr. as a tonic; 1 to 2 dr. in ague.

Preparations.

a. Of the Yellow Bark:

1. Decoctum Cinchonse Flavae

Decoctum Cinchonse Flavae. 1 in 16. Lose, 1 to 2 fl.oz.

2, Extractum Cinchonas Flavae Liquidum.- 4 in 1. Dose, 10 to 30 min.

3. Infusum Cinchonae Flavae

Infusum Cinchonae Flavae. 1 in 20. Dose, 1 to 2 fl.oz.

4. Tinctura Cinchonae Flavae

Tinctura Cinchonae Flavae. 1 in 5. Lose, 1/2 to 2 fl.dr.

5. Quiniae Sulphas.

b. Of the Pale Baric (Cinchona Pallida):

1. Tinctura Cinchonae Composita

Tinctura Cinchonae Composita. Pale Bark, Bitter-Orange Peel, Serpentary, Saffron, Cochineal, and Proof Spirit. 1 in 10. Dose, 1/2 to 2 fl.dr.

c. Of the Bed Bark there are no officinal preparations. D. Of the Lance-leaved Cinchona Bark: Quiniae Sulphas.

Action And Uses

The action and uses of the Cinchona harks will he described along with those of Quinia, their most important active principle.

Quiniae Sulphas - Sulphate of Quinia. (C20 H14N2O2)2H1SO4.7H1O. - The sulphate of an alkaloid, prepared from yellow Cinchona bark, and from the bark of Cinchona lancifolia, Mutis.

Source. - Made by (1) exhausting the bark with Diluted Hydrochloric Acid; (2) precipitating the Quinia with Solution of Soda; (3) dissolving this in Diluted Sulphuric Acid; and (4) crystallising out.

Characters. - Filiform silky snow-white crystals, with an intensely bitter taste. Solubility, 1 in 576 of water: 60 gr. require 60 min. of diluted sulphuric, or 100 min. of diluted phosphoric acid; and 66 gr. require 60 min. of diluted nitric acid for solution in two ounces of distilled water. 12 gr. = 1 oz. of good bark.

Impurities. - Sulphates of the other cinchona alkaloids, and of lime, chalk, magnesia; starch, boracic acid, etc.; detected by the quantitative test given above. Salicin; which gives blood-red with sulphuric acid.

Incompatibles. - Alkalies and their carbonates, astringent infusions. Nitric acid alone makes a clear mixture with sulphate of quinia.

Dose. - 1 to 5 gr. as a tonic; larger doses as an antipyretic and antiperiodic.

Preparations.

1. Ferri et Quinia Citras, - 16 in 100. Dose, 5 to 10 gr.

2. Pilula Quiniae

Pilula Quiniae. 1 with 1/3 of Confection of Hips. Dose, 2 to 10 gr.

3. Tinctura Quiniae

Tinctura Quiniae. 1 in 60. Dose, 1 to 1 1/2 fl.dr.

4. Tinctura Quinise Ammoniata

Tinctura Quinise Ammoniata. 1 in 60 of Solution of Ammonia and Proof Spirit. Dose, 1/2 to 2 fl.dr.

5. Vinum Quiniae

Vinum Quiniae. 1 in 480 of Orange Wine, with Citric Acid.

Dose, 1/2 to 1 fl.oz.

Action And Uses. 1. Immediate Local Action And Uses

Externally. - Quinia arrests some kinds of fermentation and decomposition, and might he used as a local antiseptic and disinfectant to wounds and ulcers, but for its cost. A solution I of 2 gr. to 1 fl.oz., applied as a spray to the nose, relieves hay asthma. A solution of 4 gr. to 1 fl.oz. (with a minimum of diluted sulphuric acid) is recommended as a constant application in diptheritic conjunctivitis, or to wash out a foul bladder.

Internally. - Quinia is freely absorbed by the mucous membranes, and may be given either by the mouth, rectum, or subcutaneously. In the mouth, stomach, and intestine, it acts as a powerful bitter, possessing all the important influence on the secretions of the digestive tract described under Calumba. The stomachic effect of quinia is obtained from small doses, \ to 2 grains, and must be kept entirely distinct from the specific effects to be presently described, otherwise confusion as to the action and value of this important drug will be the result. In small doses, like all other bitters, it improves the appetite and digestion, stimulates the heart and circulation, increases the sense of comfort and bien etre produced by a meal; and its continued use will thus increase the bodily strength, that is, will be tonic in its effects. Quinia is extensively used for this purpose, especially during convalescence, in debilitated subjects, and in patients taking depressing or alterative remedies such as mercury. Larger doses (10 to 30 gr. or more), have the opposite effect, interfering with digestion, and so causing depression.

In the stomach quinia or its sulphate becomes the chloride, a soluble and diffusible salt, which readily enters the blood. Little or none escapes unabsorbed in the faeces.

2. Action On The Blood, And Its Uses

Quinia or its chloride may be found in the blood within a few minutes of its administration. Here the alkaloid produces several definite effects, namely: (1) It binds the oxygen more firmly to the haemoglobin, so that oxygenation is lefts easy and less active. (2) It causes enlargement of the individual red corpuscles. (3) It paralyses the leucocytes, when given in large doses, thus checking diapedesis; and reduces the number of visible leucocytes very greatly (to one-fourth). In blood freshly drawn, it (4) retards the formation of acid (through loss of oxygen and increase of carbonic acid) which naturally occurs in Wood removed from the vessels, as well as (5) the ozonising power of blood, e.g. on guaiacum and turpentine. Altogether, quinia manifestly interferes with oxygenation, the giving up of oxygen by the red corpuscles to oxydisahle bodies, and with the function of the white corpuscle. The outcome of these effects will be presently considered.

3. Specific Action

Quinia passes through the tissues without decomposition, quickly making its appearance in them, but not being completely excreted for several days. The maximum effect of large doses is produced in about five hours. If therefore the full specific effect be desired, a single large dose (15 to 30 gr.) must be given, and this may have to be repeated once or twice within the hour; small doses given over a length of time do not sufficiently accumulate.

The obvious phenomena produced by a full dose (15 to 30 gr.) of quinia are not by any means its most important effect. It acts most strikingly upon the nervous centres, and causes confusion of the mental faculties, noises in the ears and deafness, disorders of vision, headache, giddiness, vomiting, and possibly prostration from involvement of the cord and circulation. Of infinitely greater interest and importance are certain concomitant effects of quinia which require careful investigation for their discovery. These effects may be arranged thus: