Tyson recommends quinine in malarial hrernaturia and believes that this symp tom is due to another cause than quinine. Albert Woldert (Med. News, Apr. 30, '98).
Quinine acts nearly as a specific in all malarial fevers characterized by inter missions or well-marked remissions, but fails in continued fevers, those with typhoid-like symptoms, those malarial conditions without high temperature, and the cachexias and anremias due to malaria.
Quinine should never be used in lanmo globinuria, or given subsequently to one who has suffered from it. J. S. Van Marter, Jr. (N. C. Med. Jour.; Louis ville Med. Monthly, Sept., '9S).
Quinine should not be given in ma larial hrematuria. The injudicious ad ministration of quinine is often respon sible for an lilematuric attack. M. Coltman and William Krauss (Memphis Lancet, Dee., '98).
The Indian jail experience has settled that it is possible to daily administer preparations of quinine for many months at a time m ithout the slightest mischief o lit e :scars qui . but has twin personally - - to, on the average,•P .11, m rs ior the four months • dit .1.1, II. and never has a I 1,- ilt bei met M POI ; CVell f quininisin are conspieu s 1 thi tr rarity. It is needless t,. it. in spite of Professor Koch's A N 1. It n the subject of quinine I He .n Muria, there lias not been . Lase in II, rsonal experience, nor tl re littu found after inquiry, such A "Alike tile iracticc was introduced mt., tie pri4ons of India. W. J. Bu t koi,•n Brit. Mcd. Jour.. Sept. 1, 1900).
manageimnt of chronic tak. io xia much often depends upon It aliLl_tv or willingness of the patient e to a non-malarious and healthy ,..imate. Indeed, in some instances the J. 1 tion of such a course is absolutely to effect a cure. At the same ;lire luinine in small doses should be tal.tn for a long time to destroy the para zitt-s. rtmainitr in the blood and organs, ard azure,: should be adopted to over e profound asthenia and anmniia. TI.e indications of the former are usu .flv fuTlv met by the administration of tonics and an abundant and nutri diet. while the latter usually calls tl.e uze of arsenic: indeed, in this
i.d.tien lonz-continued treatment N• P1L r..1'11.0 in ascending doses oftenI rot., most effective; not only is this I • rw-ly of value in the treatment of the ! ? ,An.a incident to chronic malarial but it is also to be employed in tie s.me manner to combat the ame i.:1 that iz of such common occurrence the convalescence from the acute -n r f infection.
Four cases of malarial caehexia treated v,ith tl.e .pleen and bone-marrow of .
• ith arparently favorable result's. Gritmann (Allg. Wien. med. Zeit , June 30. '.9rt .
Of 5 ease-s of malarial eachexia treated N ith hypodermic injections of citrate of iron, four cases recovered completely. The fifth was greatly improved. Naame (Rev. de MM. de Paris, Mar. 10, '97).
Certain symptoms arising during the course of a malarial paroxysm may call for special treatment, but the indications to be met are only those to which eral principles may be applied and hardly seem to call for particular mention. Various substitutes for quinine in. the treatment of malaria have been advo cated, including the other derivatives of cinchona, methylene-blue, arsenic, strych nine, iodine, and a number of others. All of these, however, are far inferior to quinine in their antimalarial action, and, with the exception of arsenic under the conditions already mentioned, possess a very limited applicability.
Of 2501 men on w-hom arsenic was tried, 579 were suffering front acute and 138-1 from chronic malaria. The remain ing 538 were free from the disease. In the acute cases arsenic was of little use, but it gave excellent results in the chronic cases, and in the others it seemed to confer immunity, or, if they con tracted the affection. it was of a mild type and easily cured with quinine. The men put on flesh, and lost the pallid, eachectic look characteristic of dwellers in malarial regions. Daily administration of arsenous acid increases the resistance of the organism to the action of the microbes of malaria. Ricchi (Brit. Med. Jour., Apr. 27, '89).