This section is from the book "A Treatise On Therapeutics, And Pharmacology Or Materia Medica Vol1", by George B. Wood. Also available from Amazon: Part 1 and Part 2.
For the method of effecting subcutaneous injection, and the instruments employed, the reader is referred to page 81 of this volume. To Obtain the salt of quinia in the liquid form, it is necessary either to use the bisulphate, which is much more soluble than the sulphate, or, what is still better, to add just as much of the diluted sulphuric acid, or of one of the vegetable acids, as the acetic, citric, or tartaric, as may be necessary for the solution of the sulphate in the admissible quantity of water, which for one dose should not exceed twenty or thirty minims. It is important not to use more acid for the purpose; than is necessary to solution, because in excess it acts as an irritant to the tissues. The dose of the sulphate of quinia may be from one-third to one-half that given by the mouth for the same purpose. For antiperiodic effect, four or five grains may be given two or three hours before the expected paroxysm; and if postponed still later, even to within an hour or three-quarters of the chill, some effect may be expected. The solution may be injected in either of the extremities, or in the trunk along the spine. On the whole the arm is the most convenient.
Friction upon the surface with sulphate of quinia, in the form of liniment or ointment, has also been recommended. For this purpose, a drachm of the sulphate, finely powdered, may be incorporated with two drachms of lard; but it would be better that the salt should be preliminarily dissolved, as it is more readily absorbed in this state. The following formula is essentially that of M. Boudin. Dissolve a drachm of sulphate; of quinia in the least possible quantity of alcohol, with the aid of a little aromatic sulphuric acid, and incorporate the solution with four drachms Of melted lard. The salt being soluble; in oleic acid, or pure lard oil, M. Lhermite recommends to dissolve one part of it in ten parts of the oil, with the aid of a gentle heat; the oil being previously scented with an agreeable volatile oil, as that of bergamot, for example. Either of these preparations may be rubbed, ad libitum, upon the inside of the upper or lower extremities, or in the axilla.
The idea of bringing young infants under the influence of quinia through the milk of the mother, by administering the medicine to the latter, has suggested itself to practitioners; but the alkaloid is probably not thrown off with this secretion; at least numerous attempts to detect it in the milk of women under its influence have failed. This plan, therefore, should never be relied on, and is the less necessary, as it is very easy to give the remedy to the child directly, by resorting to some expedient for covering the taste.
Other Salts of Quinia. Numerous other salts of quinia have been recommended, on various grounds, as substitutes for the sulphate. The acetate, antimoniate, arsenite, and arseniate, citrate, ferrocyanate, lactate, muriate, tannate, and valerianate, have severally had their peculiar advocates; but the insolubility of most of them is one objection; and. though this may be overcome by the acid of the stomach, or the addition of an acid previously to administration, yet there exists another objection; that, namely, as they act through the quinia they contain, and all of them have a less proportion of this than the sulphate, in consequence of the higher combining number of their acid, they must be proportiona-bly less efficient, even when dissolved. Besides, experience has failed to establish any superiority of any one of them over the sulphate, except as regards the taste; and, in relation to the salts with arsenious and arsenic acids, they cannot be given in quantities sufficient to obtain the influence of quinia over the system, without incurring the risk of danger from the arsenical ingredient. Of the above named salts, the valerianate of quinia (Quiniae Yalerianas, U. S.) is officinal; and directions for its preparation are given in the U. S. Pharmacopoeia. It is soluble in 110 parts of cold and 40 of boiling water, in 6 parts of cold and an equal weight of boiling alcohol. It has a strong disagreeable odour of valerianic acid. It is peculiarly applicable to debility combined with nervous disorder, and may be found useful in some cases of neuralgia, and hemi-crania. The dose is one or two grains, three or four times a day.
Crude Quinia. In the process for preparing sulphate of quinia, after the evaporation of the alcoholic solution, and before the addition of sulphuric acid, a semiliquid substance is obtained, which, being dried, constitutes the substance here referred to, under the name of crude quinia. It has a resinous aspect, and a brownish-fawn colour more or less deep, is softened by heat so as easily to be formed into pills, is much less bitter than the sulphate, and consists, as procured from Calisaya bark, mainly of quinia, which is mixed with whatever other alkaloids may exist in the bark, and more or less colouring and perhaps resinous matter. It has all the effects of sulphate of quinia, and may be employed for the same purposes. Though but very slightly soluble in water, it is readily dissolved by the addition of an acid, and is consequently soluble in the gastric liquor. From its comparative want of taste, it is applicable to infantile cases. The only objection to it is that, from its want of a precisely definite composition, it cannot be so readily guarded against adulteration. It may be given in the same doses as sulphate of quinia, either in pill, or suspended in water. Dissolved by means of an acid, it acquires the bitter taste of the sulphate.