420 
Ejffects  of  Quinine  on  Tissues. 
Am.  Jour.  Pharm. 
June,  1920. 
The  essential  oils  of  these  oleoresins  have  in  a  few  cases  been 
examined  and  some  of  their  constituents  determined.  Thus  in 
Manila  elemi  and  that  of  Southern  Nigeria  and  of  Uganda  the  odor 
of  phellandrene  is  prominent.  Limonene  is  also  present  in  some 
varieties,  and  in  one  terpinene  and  terpinolene.  But  the  possible 
uses  of  these  oils  in  varnish  making  and  in  perfuming  soap  have  yet 
to  be  worked  out. 
EFFECTS  OF  QUININE  ON  THE  TISSUES.* 
There  are  circumstances  in  which  the  vigorous  action  of  adequate 
quantities  of  quinine  in  the  circulation  is  highly  desirable.  The 
alkaloid  itself  is  rather  insoluble;  but  some  of  the  salts  of  quinine 
are  fairly  soluble,  and  are  absorbed  with  considerable  readiness  from 
the  gastro-intestinal  canal.  The  "Pharmacology  of  Useful  Drugs, 
issued  by  the  American  Medical  Association,  makes  it  seem  prob- 
able that  too  much  importance  has  been  attached  to  the  influence 
of  the  degree  of  solubility  of  the  salts  of  quinine  in  their  absorp- 
tion, and  too  little  attention  to  the  selective  capacity  of  the  gastro- 
intestinal tract  for  absorbing  them.  In  the  United  States,  in  con- 
trast with  European  countries,  quinine  sulphate  is  the  salt  generally 
prescribed,  although  the  hydrochloride  is  decidedly  more  soluble 
and  ought  to  be  preferred.  However  that  may  be,  numerous  en- 
deavors have  been  made  to  secure  more  effective  quinine  therapy, 
particularly  in  malaria,  by  modes  of  administration  other  than  the 
usual  oral  path. 
Baccelli  first  suggested  the  intravenous  injection  of  solutions  of 
salts  of  quinine  when  the  symptoms  of  malaria  are  so  severe  as  to 
threaten  grave  peril  to  the  patient.  Subcutaneous  or  intramus- 
cular injection  has  also  been  recommended  and  frequently  em- 
ployed, particularly  in  critical  cases.  Despite  the  use  of  care  in 
giving  such  treatment,  much  discomfort  and  pain  may  be  caused; 
and  even  if  aseptic  precautions  are  studiously  applied,  a  consider- 
able amount  of  induration  if  not  actual  abscess  formation  is  likely 
to  occur  at  the  site  of  injection.  Most  therapeutists  recognize  this 
danger  and  warn  against  it. 
That  tissue  necrosis  is  produced  by  strong  solutions  of  quinine 
salts  need  not  be  a  surprise  when  it  is  recalled  that  for  more  than 
*  From  Jour.  Amer.  Med.  Assoc.,  Feb.  14,  1920. 
^  Hatcher,  R.  A.,  and  Wilbert,  M.  I.:  "Pharmacology  of  Useful  Drugs," 
Chicago,  Amer.  Med.  Assoc.,  191 5. 
