August i, 1890.] 
THE TROPICAL AGRICULTURIST. 
7 29 
A FEW PRACTICAL SUGGESTIONS 
CONCERNING QUININE. 
By Professor Dr. C. Binz of Bonn. 
The study of the employmeut of quinine in uncivilised 
fever lands leads to the conclusion that in such coun- 
tries it is to the traveller as essential as gunpowder. 
The one he must have to protect his existence and 
property against greedy and treacherous native chiefs, 
and the other to secure his life against the malaria 
fever. 
G. Schweinfurt relates that he rendered himself 
imoof against the effects of a prolonged sojourn in 
pestilential swamps by the fortifying influence of 
quinine taking J gramme* three times a day. It was 
an extreme case. For by the very nature of his occu- 
pation, namely, botanising in the swamps and wading 
among the papyri, he was completely exposed to the 
malaria, and constantly inhaling its fatal breath. 
Nevertheless his health remained unimpaired until by 
return to the pure air of the interior he was enabled 
to dispense with the further use of quinine. (Im 
Herzen von Africa. Keisen and Entdeckungen 1874 
I. 137 und 352.) 
In his work “Through the Dark Continent,” H. 
Stanley tells us how three attacks of fever reduced 
him seven pounds in weight. But be “ quininized ” 
himself thorcughly from dawn till sunset, and came 
out on the fifth day pale, weak, trembling, with 
jaundiced eyes, beating heart, and singing ears, but 
the fever was overcome. And in his book on the Congo 
he speaks of another fierce attack of fever which he 
also conquered by large doses of three, and three 
and a half grammes of quinine, together with a few 
drops of bydrobromic acid and a little Madeira. He 
felt the strong medicament stream like lightning 
through his veins, and gradually' creep with overwhelm- 
ing force over his senses. But twenty our hours sleep 
followed, the fever was gone, and though terribly 
reduced in strength he was able to slowly recover. 
C. Nachtigal briefly terms quinine “the greatest of 
treasures to travellers in tropical regions.” 
1 give the above as only a few voices among count- 
less others. Respecting the value and importance of 
quinine, the evidence is vast and unanimous. 
It teaches us that in preparing for a journey to 
fever-stricken lands, quinine should be obtained in the 
very best, purest, most effectual form. This is how- 
ever very rarely the case. The consequence is that 
the most serious risks are constantly incurred. Tra- 
vellers and oflBcials even lose their lives, or have to 
change their plans, or give them up altogether. To 
remedy this so far as lies in my power, I beg to 
submit to you (Deutsche Colonial-Zeitung) the follow- 
ing observations- They are the result of years of 
constant practical and experimental study of the subject. 
The two chemists who first produced quinine from 
the Cinchona bark, did so in the form of the sulphate, 
and probably more by accident than intention. At 
all events in that form quinine passed into commerce, 
and so has remained for the last fifty years. Most 
physicians from habit and custom know and pres- 
cribe only the one salt; most phnrmaoopeoias even 
know no other, and in the last Prussian, it also 
remained the only recognised form of quinine, until 
on my proposition, the hydrocblorate was also 
included in the German pharmacopoeia of 1872. Since 
then the consumption of the hydrochlorate has 
gradually increased, but still remains considerably 
smaller than that of the sulphate, about 1,750,000 oz. 
of the former being consumed in the world, against 
about 5,250,000 oz. of the latter. There are civilised 
countries, as North America for example, where even 
now the sulphate is exclusively in vogue. 
"Without being a chemist, one can easily under- 
stand the difference between the two kinds, remem- 
bering their difference in solubility in water. The 
sulphate demands about 800 times its weight of dis- 
tilled water to dissolve perfectly, whereas the hy- 
drocldoralo requires only .50 tunes. ^ 
* About 7| grains.— Ed. T. A. " " ’ 
t 23 grains.— Ed. T. A. 
17 
By the addition of a little free acid the so'nbility 
is increased, but also in such case greatly in favour 
of the hydrnchlorate over the sulphate. What is the 
consequence? As long as the human stomach is in 
a healthy condition it developes of itself free hydro, 
chloric acid snflScient to change even the sulphate of 
quinine into that fo' m in whi h it can be mo u readily 
assimilated. But whenever the stomach becomes sub- 
ject to disorders involving the diminution, or even 
total disappearance of such natural acid, the power 
of solution and assimilation of course terminates, and 
the medicament that by reason of its low specific 
gravity is very voluminous, remains as so much worse 
than useless balla.<t in the already weakened stomach. 
This is one reason why so many lives are lost annually 
notwithstanding administration of quinine. It is clear 
that with the sixteen times greater solubility of the 
hydroohlorate, the risk of its remaining inoperative 
in the stomach is considerably diminished. In numeri us 
cases the hydruchlorate will dissolve and enter the 
blood, while to the sulphate this is impossible. It 
is precisely its insolubility in weakened stomachs that 
explains why in so many cases of fever, the other- 
wise so potent and reliable quinine is absolutely 
useless. The quinine passes for the most part into 
the lesser intestine where the conditions for assimi- 
lation by the blood are the more unfavourable, since 
the reaction here is purely alkalic, rendering solution 
even more d fficult. 
The addition, or the drinking afterwards of any 
acid beverage that is otherwise sui able or congenial 
to the stomach, of course greatly tends to facilitite 
the assimilation of the quinine. Stanley was quite 
right in taking hydrohromic acid and Madeira. The 
former, however, that is in general difficult to procure, 
and an acid moreover that readily decomposes, was 
not absolutely neces.sary. Diluted muriatic acid would 
have done equally well, or any agreeable fruit acid. 
All good spirituous drinks are also energetic solvents 
of quinme. Such however are not always obtainable 
when travelling in fever countries, or for other rea- 
sons may not seem advisable to administer. In such 
case, the best of all aids is strong carbonic acid water. 
One should, however, take with on« that preparation 
of quinine which in all cases is the most easily assi- 
milated. and that is the liydrochlorate. 
Up till wituin the last few years impure or even 
intentionally adulterated quinine often changed hands 
in commerce. A criminal suit in Berlin in 1886, and 
another in Paris in 1883 on account of such adulterations 
created some sensation at the time. The most 
frequent surrogate were the subsidiary alcaloides of 
the Cinchona bark that are much cheaper than quinine 
itself, but also much less effective against the 
Malaria poison. Things in this respect have grown 
better, the more so since quinine has seemingly 
fallen permanently from the high price to which it 
was driven by speculation. Tet whoever visits the 
interior of Africa must not rely simply upon the 
improved quality of quinine. He must obtain his 
supply from the best sources and even then submit 
it to the prescribed tests. 
Much has been lately spoken on the question 
whether quinine has a preservative influence against 
fever. It is obvious that this question is of the 
greatest practical importance. In my opinion the 
matter lies thus. 
In consequence of imperfect trials, one came to 
the conclusion that quinine exercised no really 
prophylactic influence, and this opinion was accepted 
and promulgated by certain careless editors of medical 
handbooks. In reality, however, too little quinine had 
been administered, or if enough, in inappropria'e 
form. Other physicians who had examined tiw' 
matter with more care and attention met with boitet- 
results quite in accordance with Stanley and ScLweiu- 
furth’s own personal experience. I am inclined ti, 
lay the more stress upon this, since the errors ia 
treatment referred to can be easiiy recognised. Fre^ 
experiments have been recently tcjide by Dr. C. 
Graeser who published the reaulta in the Berliner 
klinisohe Woclienschrift 1888 No. 42. As navy- 
ur geon in the Dutch service he had ample oppo - 
