264 MATERIA MEDIC A AND THERAPEUTICS. 



corpuscles. (3) It paralyses the leucocytes, when given in 

 large doses, thus checking diapedesis ; and reduces the number of 

 visible leucocytes very greatly (to one-fourth). In blood freshly 

 drawn, it (4) retards the formation of acid (through loss of oxy- 

 gen and increase of carbonic acid) which naturally occurs in 

 blood removed from the vessels, as well as (5) the ozonising 

 power of blood, e.g. on guaiacum and turpentine. Altogether, 

 quinia manifestly interferes with oxygenatiOn, the giving up 

 of oxygen by the red corpuscles to oxydisable bodies, and with 

 the function of the white corpuscle. The outcome of these 

 effects will be presently considered. 



3. SPECIFIC ACTION. 



Quinia passes through the tissues without decomposition, 

 quickly making its appearance in them, but not being com- 

 pletely excreted for several days. The maximum effect of 

 large doses is produced in about five hours. If therefore the 

 full specific effect be desired, a single large dose (15 to 30 gr.) 

 must be given, and this may have to be repeated once or twice 

 within the hour ; small doses given over a length of time do not 

 sufficiently accumulate. 



The obvious phenomena produced by a full dose (15 to 30 gr.) 

 of quinia are not by any means its most important effect. It 

 acts most strikingly upon the nervous centres, and causes 

 confusion of the mental faculties, noises in the ears and deaf- 

 ness, disorders of vision, headache, giddiness, vomiting, and 

 possibly prostration from involvement of the cord and circula- 

 tion. Of infinitely greater interest and importance are certain 

 concomitant effects of quinia which require careful investigation 

 for their discovery. These effects may be arranged thus : 



(1) Quinia lowers the body temperature very moderately 

 in the healthy subject ; very markedly in the pyrexia of many 

 acute specific fevers. It appears to be difficult to lower the 

 normal temperature by drugs, as compensating mechanisms are 

 probably brought into play ; but the rise of temperature and 

 the perspiration normally produced by muscular exercise are 

 prevented by quinia. In malarial fevers, typhoid, acute 

 pneumonia, and some forms of hectic and other periodic fevers, 

 the defervescent effect of quinia is unquestionable. 



(2) Quinia reduces the amount of nitrogenous excretions, 

 i.e. urea and uric acid, and probably also of carbonic acid, as 

 determined both in healthy and in fevered animals, and in man. 



These two sets of effects taken together point to a powerful 

 action of quinia in reducing the metabolism of the body, of 

 which heat and the excretions are the two most measurable 

 products. This conclusion is supported by other facts, observed 



