February, 1916.] Annual Address. 



xxv 



protest only led to his being turned out of Calcutta and ci sus- 

 pended from his appointment in the service." Fortunately 

 for the lot of reformers of medical treatment it is not now as 



an 



some unpleasant experiences. As the result mainly of James 



Johnson's pernicious teaching, and in spite of the discovery of 



quinine in 1820 and its introduction into India in 1825, for 



forty years malarial fevers in India, and especially in Bengal, 



were treated mainly with the deadly excessive doses of mercury, 



and cinchona and quinine were only permitted to be used in 



small doses after the temperature had declined to normal. 



The story of the reintroduction of large doses of cinchona in 



the form of its active alkaloid quinine, given during fever, is a 



most interesting one. Edward Hare came to India in 1839 



and in 1842 he had to treat malarial fever in the deadly Nepal 



Terai and found that his patients died before the mercury had 



time to affect them, and he wrote "no remissions took place, 



there were head symptoms, and I durst not give quinine. In 



fact it was so utterly forbidden by all authorities that it never 



occurred to me to give it." One day he was left a library by a 



medical man whom he had unsuccessfully treated for cholera, 



and in it he found the even then rare works of Lind and Hunter, 



and it at once struck him as remarkable that since the discovery 



of quinine no one had used it in large doses during fever in the 



ulated 



way that they had formerly given cinchona bark, although 

 quinine presented obvious advantages over the massive doses 

 of bitter sawdust which the older physicians had to rely on. 

 Soon after a European deserter was brought to Hare by villagers 

 m the deadly coma of cerebral malaria, and with rare courage 

 he proceeded to administer twenty- grain doses of quinine 

 three times a day, and much to his surprise cured him in 

 two days. 



evidence of the value of quinine during fever in malaria and 

 m 1847 he published a pamphlet in Delhi, which took the 

 profession by surprise and created such a great sensation 

 throughout India that the Calcutta Medical Board obtained the 

 sanction of Lord Dalhousie to bring Hare down to Calcutta 

 and placed him in charge of a wing of the General Hospital, 

 where in a single year he reduced the death-rate from fevers 

 to one-twelfth of its average rate for the previous twenty 

 years. The Medical Board published an official report of the 

 trial throughout India, and Hare's system of treatment has been 

 used ever since, although the old prejudice against giving 

 quinine during fever still persists in some lay minds Hare 

 became Inspector-General of Civil Hospitals in Bengal, but 

 does not appear to have received any other recognition of his 

 work, which must have saved more lives than any other discov- 

 ery in the history of medicine in India. There is still, however, 

 much to be learned regarding the therapeutical value of the 



