In the treatment of coryza:

Cinchona Rubra Red Cinchona Continued Continued 587

or

Ext. Belladon. Fol. .........

gr. ss

03

Camphorae..............

gr. vj

40

Quininae Sulph.,

Pulv. Ipecac, et Opii...................

aa.gr. xij

80

M. ft. cap. no. xij.

Sig

One every half-hour for four hours, then one every three hours.

1Shoemaker: Materia Medica and Therapeutics. 2 Musser and Kelly: Practical Treatment.

In the treatment of grip, cold, etc.:

Cinchona Rubra Red Cinchona Continued Continued 588

or

Caffeinae Citratae............

gr. x

65

Quininae Hydrobrom.............

gr. xx

1

30

Acidi Acetylsalicyl................

gr. L

3

00

M. ft. cap. no. xvj.

Sig

One every two hours till eight (8) are taken each day.

In the treatment of chronic heart disease:

Cinchona Rubra Red Cinchona Continued Continued 589

or

Digitalis Pulv,

Quininae Hydrochlor.............

āā. gr. xv

1

0

Ext. Valerianae..............

3j

4

0

M. ft. cap. no. xxx.

Sig

One three times a day.

The principle in preparing a so-called"tasteless"quinine is to use a salt that will dissolve only to the smallest possible extent, so it will not come into contact with the special nerve-endings in such form as to be appreciated. The sulphate is probably the best salt for this purpose. The tannate is less bitter but has to be given in large amounts and at least is slower and more uncertain in action.

It is usually possible to ascertain the preference of the child as to flavor. Glycyrrhiza may be distinctly disagreeable to some, while syrup of chocolate would be very acceptable.

Some adults and practically all small children are unable to swallow capsules. The prescriber should always ascertain as to this matter before writing his prescription. If patient is a child 8 to 10 years of age, but has never been tried on capsules, the prescription may be written for that form and the nurse instructed to empty them and administer in syrup of chocolate if the capsules cannot be swallowed. This method is sometimes desirable, anyway, as, for example, when other agents are ordered with the quinine salt that cannot well be put in solution. To illustrate: The following has been used for a child 6 years old, to follow the customary three days' intensive quinine treatment for malaria:

Cinchona Rubra Red Cinchona Continued Continued 590

or

Arseni Trioxidi,

Strychninae Sulph...............

āā. gr. 1/3

002

Quininae Sulph.,

Ferri Reducti.....................

āā. gr. l

3

000

M. ft. cap. no. l.

Sig

One after meals as directed.

1 Musser and Kelly: Practical Treatment.

A"tasteless"syrup for administration to a child:

Cinchona Rubra Red Cinchona Continued Continued 591

or

Quininae Sulphatis............

gr. xvj

1

Syr. Eriodictyi Arom............

q. s.Cinchona Rubra Red Cinchona Continued Continued 592

60

M.

Sig

Five (5) teaspoonfuls each day as directed. (Shake-label.)

Syrup of glycyrrhiza or syrup of chocolate may be ordered as the vehicle in the above.

In the treatment of malaria (child 6 years old):

Cinchona Rubra Red Cinchona Continued Continued 593

or

Quininae Sulphatis..............

gr. xxx

2

Ft. cht. no. xviij.

Sig

Six (6) powders in chocolate syrup each day as directed.

Bitter Solutions

These are frequently desirable for adults and sometimes for children. Some combinations are shown in the following:

As a bitter tonic to follow the intensive treatment of malaria:

Cinchona Rubra Red Cinchona Continued Continued 594

or

Quininae Sulphatis ...............

3iiss

10

Tinct. Ferri Chlor. ................

f3vj

23

Liq. Acidi Arsenosi.............

f3ij

8

Aquae................

q.s.Cinchona Rubra Red Cinchona Continued Continued 595

180

M.

Sig

Teaspoonful in water after meals.

Cinchona Rubra Red Cinchona Continued Continued 596

or

Quininae Sulphatis..........

3iiss

10

Acidi Sulph. Arom.............

f3ij

8

Elix. Aromatici..............

q. s.Cinchona Rubra Red Cinchona Continued Continued 597

180

M.

Sig

Teaspoonful in water before meals.

Hypodermic Use

This method is sometimes employed, particularly when it is desirable to get the patient rapidly under the influence of the drug. Quinine Hydrochloride is sometimes used but Quinine Dihydrochloride is even more desirable for this purpose. It is soluble in less than its own weight of water.

Quinine and Urea Hydrochloride is soluble in its own weight of water, so is a valuable form for hypodermic use. Hypodermic employment is, of course, confined to the physician himself. He may use the tablets and prepare the solutions extemporaneously or order them as follows:

Cinchona Rubra Red Cinchona Continued Continued 598

or

Quininae Dihydrochlor...........

3j

4

0

Aquae Destillatae............

q. s.Cinchona Rubra Red Cinchona Continued Continued 599

15

0

M.

Sig

Formula.

Or:

Cinchona Rubra Red Cinchona Continued Continued 600

or

Quin. et Ureae Hydrochlor...........

gr. xxx

2

00

Aquae Dest...............

q.s. f3j

4

00

M.

Sig

Formula.

These solutions should be given largely diluted and even then there is frequently slow absorption, local irritation, and, it is claimed, sometimes even tetanus.

Intravenously

Considered by many as preferable to the hypodermic method. The solutions, as just stated for hypodermic use, may be employed only largely diluted with normal saline.

By Rectum

The administration of quinine in the Murphy drip for constitutional effect is probably practical and worthy of more thorough investigation.

Other Uses

The salts of quinine are sometimes used in enemas, as the following for amebic dysentery:

Cinchona Rubra Red Cinchona Continued Continued 601

or

Quininae Sulphatis.........

Cinchona Rubra Red Cinchona Continued Continued 602

30

Ft. cht. no. x.

Sig

Use one to 1/2 gallon of warm water as directed.

Or the following for pinworms in a child:

Cinchona Rubra Red Cinchona Continued Continued 603

or

Quininae Bisulphatis.............

gr. xxx

2

Quassiae...............

Cinchona Rubra Red Cinchona Continued Continued 604

30

Sig

Make a tea with 1/2 gallon hot water and use as directed.

Quinine and its salts are sometimes used in hair tonics, ointments, etc.

In the treatment of alopecia:

Cinchona Rubra Red Cinchona Continued Continued 605

or

Resorcinolis........

gr. lxxx

5

0

Quininae................

gr. xv

1

0

Olei Ricini...................

Cinchona Rubra Red Cinchona Continued Continued 606 xx

1

3

Alcoholis...................

q. s.Cinchona Rubra Red Cinchona Continued Continued 607

120

0

M.

Sig

Apply as directed.

1 Stelwagon: Diseases of the Skin.