93 



greatest reliance." In the chill he gives a large dose of quinine and 

 laudanum, but does not say how much. After the paroxysm, qui- 

 nine and calomel, four or five grains of each every two, three, or 

 four hours, continuing till the apyrexial period is past, and sometimes 

 for a day or two longer. 



Dr. Fee,* of Leatherwood, considers quinine, 1st, as a tonic, in 

 doses of one or two grains three or four times a day; 2d. An anti- 

 periodic, which effect it produces in two ways ; by giving tone to the 

 nervous system, and thus preventing the return of nervous irritation ; 

 and by its sedative or quieting influence, keeping down nervous irri- 

 tation till the paroxysmal time passes. The first it effects in one and 

 two grain doses — the last in fifteen or twenty grain doses. 3d. Se- 

 dative in fifteen or twenty grain doses — this effect being promoted by 

 the addition of morphine. 4th. Anti-congestive ; an effect produced 

 in two ways — in small doses when the congestion is owing to a weak- 

 ened state of the system, with lack of nervous energy — in mammoth 

 doses when the nervous energy is normal, but the nerves too irritable. 

 5th. Narcotic ; in virtue of which power it produces ringing of the 

 ears, blindness, deafness, &c. ; for the nervous energy of the heart 

 being lessened, less blood is sent to the brain. 



Dr. Harris,f of Wetumpka, Alabama, says the dose should 

 be ten or fifteen grains, but does not tell at what interval, or how 

 often it may be repeated. In the congestive form he gives five or 

 six grains every one or two hours till twenty-five or thirty grains 

 have been taken. 



Dr. R. S. Holmesf says, "The largest amount of quinine I 

 have ever given at one dose is eighty grains. This is the extreme 

 dose: the average quantity is about twenty grains. 



In view of the rash and heedless use which is now being made 

 of this medicine, it becomes a question of deep importance for us 

 to decide what is a poisonous dose of quinine, and what symptoms 

 characterize that effect. Prof. Dickson, in the paper cited, says its 

 poisonous effects are shown by "a collection of symptoms resembling 

 those which characterize the very class of fevers in which this medi- 

 cine is most clearly indicated, and is most absolutely necessary to 

 our hopes of cure." In the case of Mrs. Bazire, a " serious attack of 

 intermittent fever," there followed a state of "stupor, with heaviness 

 of head, giddiness, difficulty of moving, amaurosis, and deafness." 

 After the large dose mentioned, these symptoms increased, she be- 



* West. Journ. of Med. and Surg., March 1848. f Ibid., Feb. 1847. 



% South. Med. and Surg. Journ., March 1847. 



