QUININE 



1191 



In addition it may be necessary to resort to intramuscular injections of 

 15 grains of quinine daily, and it is sometimes advisable to alternate this, 

 every other day, by a subcutaneous injection of the phosphorated oil of the 

 British Pharmacopceia in doses of from i to 4 minims. 



The above forms the quinine-phosphorus-tartar-emetic treatment for 

 malarial relapses devised by Castellani, and found useful by QuareUi and others. 



Baccelli's mixture, slightly modified, has the following formula: Quin. 

 bisulph., gr. 8; ferri perchlor. (Ital. Pharm.), gr. 3 ; liq. Fowleri, Tl\.|; aq. to §i. 

 It is very bitter. 



E. Chronic Malaria. 



Chronic malaria should be treated by the methods given just 

 above for relapses. Intramuscular injections of quinine are specially 

 useful in this condition, and should be given in courses of fifteen 

 daily injections. The courses should be repeated two or three 

 times after varying intervals. 



F. Malaria in Pregnancy. 



Give the usual twenty-four hourly dosage of quinine, but divide 

 it up into small individual doses of 2 to 5 grains. 



G. Malaria in Children. 



The dosage of quinine for children is as follows : — 



Age of Child. 



Dose of Quinine. 



Number of Doses in 

 Twenty-four Hours. 



Under twelve months 

 I to 3 years 

 3 to 10 years . . 

 10 to 16 years . . 



^ to grains, 



1 to 2 grains. 



2 to 3 grains. 



3 to 5 grains. 



Six. 

 Six. 

 Six. 



Six. 



H. Remarks. 



It may be thought that in the above we have been too dogmatic, 

 but our excuse 'is that we desire to lay before the practitioner our 

 experience of many years of tropical practice. 



Fig. 626. — Temperature Chart to illustrate the Benefit of Intra- 

 muscular Injections given at -h -i- -H + + + , as coivfPARED with 

 the Prolonged Oral Therapy of Days Previously. 



