4.3 
medicinally,  and  as,  moreover,  quinine  is  not.  stored  up  in  the  body 
as  such,* * * §  it  follows  that  the  maximum  amount  taken  medicinally, 
rarely  reaching  3  grammes  (4b'5  grains),  cannot  produce  haemolysis 
of  healthy  red  blood  cells  in  the  circulation.  'I'he  possibility  of  the 
haemoglobinuria  of  blackwater  fever  being  due  to  the  direct  action 
of  quinine  on  healthy  red  cells  in  tlie  blood  stream  is  thus  absolutely 
excluded.  That  some  other  explanation  of  the  action  of  quinine  in 
causing  blackwater  fever  must  be  sought  is  evident  also  from  the 
smallness  of  the  dose  which  ordinarily  is  followed  by  blackwater. 
Thus  in  Table  22,  in  which  thirteen  attacks  are  recorded,  five  grains 
or  more  hypodermically  and  nine  grains  or  more  by  the  mouth  were 
followed  by  blackwater  fever.  These  may  be  taken  as  representative 
amounts  required  to  produce  blackwater.  In  animals  the  hypodermic 
administration  of  quinine  fails  to  produce  haemoglobinuria,  as  the 
experiments  recorded  in  Table  23  show,  even  when  the  dose  is 
relatively  far  higher  than  in  Table  22. 
Table  23.  Haemoglobinuria  in  relation  to  quinine  in  animals. 
No,  of 
Experi¬ 
ment 
Animal 
Amount  of  quinine  bihydro- 
chloride  injected  per 
kilo  of  body  weight 
Result 
1 
Rabbit 
O'  1 3  g.  intravenously 
Death  within  an  hour. 
2 
}> 
O'o8  g.  hypodermically 
No  haemoglobinuria.  No  ill  effect. 
3 
n 
0'i6  g.  hypodermically 
No  haemoglobinuria.  No  ill  effect. 
4 
)j 
0*5  g.  hypodermically 
No  haemoglobinuria.  Convulsions  at  end  of 
if  hours;  death  at  end  of  2  hours. 
No  haemoglobinuria.  Unsteady  after  first 
injection ;  convulsions  and  death  ten 
minutes  after  second  injection. 
5 
Dog 
1 0*25  g.  hypodermically 
\  0*25  g.  hypodermically 
[  hours  later 
6 
1) 
0*15  g.  hypodermically 
No  haemoglobinuria.  No  ill  effect. 
7 
JJ 
0*2  g.  hypodermically 
No  haemoglobinuria  ;  no  haemoglohinaemia 
Death  at  end  of  one  hour. 
The  fate  of  quinine  in  the  body  is  only  partially  known.  Kleine.t 
.Vlariani.t  Schmitz§  and  Cliemsa  and  SchaumannH  sliowed  that  the 
*  Loc.  cii. 
t  fiber  die  Resorption  von  Cbininsalzen,  Zeitschr.  .  Hygiene  u.  tnfektionskranklieiten. 
Bd.  38,  S.  190. 
I  L’assorbiraente  e  I’eliminazione  della  chinina  e  dei  suoi  sali.  Atti  della  .Sodeta  per 
gli  studi  della  malaria,  1904. 
§  Ulier  die  Ausscheidung  des  Chinins  im  menschlichen  Harn,  Archiv.  f.  experimentelle 
Pathologie  und  Pharmakologie,  l<)07. 
Loc.  cil. 
