266 MATERIA MEDIC A AND THERAPEUTICS. 



10 gr. being given at any time with relation to the attack, and 

 similar doses repeated five hours before the time of the next 

 paroxysm. AH forms of malarial fever are benefited by quinia, 

 as well as many diseases and disorders of malarial origin, such 

 as neuralgia, hepatic disturbances, etc. The functions of the 

 liver must be maintained during this treatment of ague, and 

 the quinia may be combined with morphia if its effects are 

 not well marked. 



2. Febrile conditions in general are relieved by the antipyre- 

 tic effect of quinia, for instance, acute pneumonia, typhoid fever, 

 puerperal fever, and septicaemia, the exanthemata, and acute 

 rheumatism; but generally in ' very different degrees, so that 

 its value is denied in some or all of them. To be of use the 

 quinia must be very freely given (10 to 20 grains) as single 

 doses when the temperature reaches a definite height, say 104 

 Fahr. Even if apyrexia do not follow, the drug may be of 

 much benefit. In hectic fever quinia is rarely of much service ; 

 and in purely symptomatic fever, of still less use. 



3. In splenic enlargement of malarial origin quinia is given 

 with success, and in some cases of leukaematous hypertrophy. 



4. In painful nervous affections, especially headache and 

 face-ache, the effect of quinia is well marked. Some of these 

 cases are malarial (brow ague) ; but ordinary facial neuralgia 

 and toothache will frequently yield to it. Yet quinia pos- 

 sesses no direct action on peripheral nerves. 



5. The tonic action of quinia has been already referred to. 

 This is also due in part to its removal of fever, and thus of 

 restlessness, sleeplessness, and want of appetite. It further 

 modifies the processes of " secondary digestion " in the liver, 

 and may relieve hepatic disorder due to free living, especially 

 in persons who have resided in the tropics. 



5. REMOTE LOCAL ACTION AND USES. 



Quinia is excreted chiefly in the urine, as the amorphous 

 alkaloid; partly as resinoid and crystalline derivates. In 

 passing through the urinary organs it is slightly diuretic, and 

 occasionally irritates the passages. It also escapes by the skin, 

 diminishing the perspiration, and very rarely causing an 

 itching eruption, which resembles scarlatina or measles. All 

 the mucous secretions, the milk, and pathological fluids may 

 also contain quinia. 



ACTION AND USES OF THE CINCHONA BARKS. 



The cinchona barks contain but a small percentage of 

 alkaloids, and are far too bulky for use as antiperiodics and 

 antipyretics if quinia can be obtained. They are there- 



