ACTION AND USES OF QUININE 461 



corpuscles do not collect in the arterioles or migrate through, 

 their walls (diapedesis). Again, when inflammation has 

 already begun in the mesentery, quinine stops the trans- 

 migration of leucocytes and disperses those already ac- 

 cumulated in the blood vessels. Moreover, large doses 

 appear to actually lessen the number of white corpuscles 

 in the blood. The foregoing actions should make quinine 

 invaluable in checking inflammation. How great this influ- 

 ence may be, when quinine is given in medicinal doses, it is 

 •impossible to determine. 



2. Red Blood Corpuscles. — Therapeutic doses increase 

 the number of red corpuscles. The latter diminish in size 

 in febrile conditions, but, under the action of quinine (and 

 other antipyretic agencies), regain their normal condition. 

 This follows the effect of quinine in lowering temperature, 

 and is not due to any specific power of quinine exerted on the 

 corpuscles themselves. 



3. Oxidation. — Quinine hinders the red corpuscles from 

 serving as carriers of ozone and also prevents them from 

 yielding it to the tissues. In this way functional activity of 

 tissue cells is diminished and metabolism decreased. Quinine 

 also lessens the ozonizing power of vegetable juices. The 

 alkaloid prevents the development of acidity in blood outside 

 the body, which is thought to be the product of oxidation. 



Heart and Blood Vessels. — Quinine in moderate doses 

 does not affect the heart or vessels appreciably. It is some- 

 times stated that small doses reflexly stimulate the heart (in 

 stimulating the stomach), or that they indirectly stimulate 

 the heart and vessels by stimulating the whole system. 

 Quinine, in very large doses, is a depressant to the circula- 

 tion, decreasing the pulse rate, force, and tension. When 

 injected into a vein or directly applied to the cardiac muscle, 

 quinine causes diastolic arrest of the heart by paralyzing 

 the cardiac muscle or its contained ganglia. In poisoning 

 by quinine there is vascular dilatation and great fall of 

 blood pressure preceded by a temporary rise. This pheno- 

 menon follows direct action on the blood vessels. Although 



