97 



varies as much in itself, as the conditions in which it is found vary; 

 that the intervals between the attacks may be of almost impercepti- 

 ble duration, or extend to an indefinite length of time ; that the same 

 variety may exist with regard to the continuance of the attack 

 itself; that the characteristic symptoms of the disease may be sthenic 

 or asthenic, general or local, congestive or diffused, vascular, nerv- 

 ous, muscular — in short that periodicity, either in the paroxysms or 

 the exacerbations may be predicated of almost every condition, 

 healthy or morbid, of the system, — the question may well be asked, 

 is there any state which absolutely precludes the use of this protean 

 remedy? 



88. Another virtue, still, attributed to quinine, is its anti-malarial 

 effect. If we really knew what malaria was, we might be better 

 able to weigh the value of this opinion. But, as at present informed, 

 we must be content, perhaps, to say, that judging of a cause by 

 such of its effects as we can appreciate, there does appear to be 

 something like antagonism between quinine and malaria. 



89. The combinations in which quinine may be used with other 

 remedies, furnishes a subject for reflection and examination, hardly 

 less important and interesting than the one just considered. Less 

 has been written on this point than the subject deserves. From 

 much experience, we are prepared to show that it may be advan- 

 tageously given, not only in alternation with evacuants and alteratives, 

 but may be most usefully combined with these : doses being admin- 

 istered, at any period of our febrile diseases, composed of quinine and 

 alterant or evacuant medicines. 



90. Of cod liver oil, Indian hemp, aconite, and many other reme- 

 dies recently brought before the profession; of the very numerous 

 new preparations of old medicines, as well as the new applications 

 to which many of them are now successfully brought, as in the case 

 of nitrate of silver; of the physiological and therapeutical effects of 

 ether and chloroform, the Committee would willingly speak ; but they 

 have already trespassed so long on the time and patience of the As- 

 sociation, that they must hasten to conclude by touching briefly oa 

 the last subject they have to notice. 



