104 DISEASES DUE TO PROTOZOA 



The bihydrobromide is readily soluble in water, and is given to 

 those with deafness or headache or idiosyncrasy towards quinine. 

 Quinine valerianate is given to nervous people. 

 / Quinine ^ anna te is not so bitter and can be made up chocolate- 

 coated for children. 

 I Euquinine is very expensive. It is useful for women and children. 



Solubility and Equivalent Value of Salts of Quinine (after Manson). 



Amount equiv- 



If ingested quinine, especially the sulphates, are not dissolved by 

 the acid gastric juices of the stomach it is probably not dissolved at 

 all, as this is not permitted by the alkaline juices of the intestines. 

 Such quinine is then excreted practically unchanged. 



In small doses quinine is a vascular tonic, but in large doses it is 

 a cardiac depressant. 



Most of it is oxidized in the tissues. The kidney excretes it as 

 quinine dihydroxyl. 



It may cause cerebral congestion, manifesting itself as tinnitus, 

 deafness, headaches, &c. It may cause constriction of the retinal 

 arteries, followed by temporary amblvopia or degeneration of the 

 retinal ganglion cells, followed by permanent amblyopia. \^arious 

 kinds of eruptions have been reported from the use of quinine. 



Ten grains of quinine bihydrobromide contains bromine equal to 

 that in 3 grains of pot. brom., hence if this quinine is used prophy- 

 lactically for long periods mental depression may be expected from the 

 quinine and bromide. 



MODE OF ADMINISTRATION. 



Under all circumstances it is best given after food, as then there 

 is more gastric juice, the acidity of which facilitates its solubilitv. 



(i) By the mouth. 



The bisulphate or bihydrochloride are to be recommended if the 

 expense is not a consideration. They can be taken as powders, 



