30G RUBIACEiE. 



been removed, and caustic lye added, by which the amorphous alkaloids 

 will be precipitated, including quinamine if present. 



Uses — Cinchona bark enjoys the reputation of being a most valuable 

 .remedy in fevers. But the uncertainty of its composition and its in- 

 convenient bulk render it a far less eligible form of medicine than the 

 alkaloids themselves. It is nevertheless much used as a general tonic 

 in various pharmaceutical preparations. 



As to the alkaloids, the only one which is in general use is quinine. 

 The neglect of the others is a regrettable waste, which the result of 

 recent investigations ought to obviate. In the year 1866 the Madras 

 Government appointed a Medical Commission to test the respective 

 efficacy in the treatment of fever, of Quinine, Quinidine, Cinchonine and 

 Cinchonidine. Of the sulphates of these alkaloids, a due supply, 

 specially prepared under Mr. Howard's superintendence, was placed at 

 the disposal of the Commission. From the report ^ it appears that the 

 number of cases of paroxysmal malarious fevers treated was 2472, — 

 namely 846 with Quinine, 664 with Quinidine, 569 with Cinchonine, 

 and 403 with Cinchonidine. Of these 2472 cases, 2445 were cured, and 

 27 failed. The difference in remedial value of the four alkaloids, as 

 deduced from these experiments, may be thus stated: — 



Quinidine — ratio of failure per 1000 cases treated 6 

 Quinine ,, ,, 7 



Cinchonidine ,, ,, 10 



Cinchonine ,, ,, 23 



The Indian Government, acting on the recommendation of Mr. 

 Howard, has officially advised (Dec. 16, 1873) the more free use in India 

 of cinchona alkaloids other than quinine, and especially of sulpJiate of 

 cinchonidine. which is procurable in abundance from Red Bark.- Qui- 

 nidine on the other hand, which Las proved the most valuable of all, is 

 only obtainable from a few barks and in very limited amount. 



Dr. de Vry since 1876 advocates the use of what he calls Quinetum. 

 This preparation is obtained by exhausting the barks with slightly 

 acidulated water, and precipitating the whole amount of alkaloids bj- 

 caustic soda. In India the remedy is known as "the Febrifuge."^ 



Adulteration — There is not now any frequent importation of 

 spurious cinchona barks, but the substitution of bad varieties for good 

 is sufficiently common. To discriminate these in a positive manner by 

 ascertaining the percentage of quinine, which is the chief criterion of 

 value, recourse must be had to chemical analysis, a method of perform- 

 ing which has been described. Entirely worthless barks may be easily 

 recognized by means of Grahe's test (p. 363). 



Modern Works relating to Cinchona. 



The following enumeration has been drawn up for the sake of those 

 desirino- more ample information than is contained in the foregoing 



1 Blue Book — East India Cinchona Cul- ^ We heard that the Government has 



tivation, 1870. pp. 156-172.— The report purchased (April 1874) by tender between 



contains very interesting and important 300 and 400 lb. of cinchonidine. 



medical details. See also Doiigal in Edin. ^ Pharm. Journ. viii. (1878) 1060. 

 Med. Joitrn. Sept. 1873. 



