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CONTENTS.

  PAGE.
Introduction . . . 1
Peculiarities of Quinine and its salts . . . 3
Their solubility in water.        
Their deterioration (heat, light, moulds).        
Compatibility of Quinine salts with blood-serum . . . 6
Solubility of Quinine alkaloid in blood-serum . . . 11
Solubility of Quinine alkaloid in bile . . . 11
Absorption of Quinine . . . 13
Quinine elimination in the urine as a gauge of the amount of Quinine absorbed . . . 13
Lethality as a measure of the amount of Quinine absorbed . . . 15
A. Oral administration . . . 15
Seat of absorption of Quinine . . . 15
Factors influencing absorption from the gastro-intestinal tract . . . 18

   (1)Food contents of the gastro-intestinal tract.

   (2)Affections of the gastro-intestinal tract.

   (3)Affections of the liver.

   (4)The solubility of the Quinine salt employed.

     The value of the lethality gauge as compared with Quinine elimination
in the urine as a measure of Quinine absorption.

   (5)Carbon dioxide.

   (6)Single large doses of Quinine as opposed to divided or " fractional " doses.

The efficacy of Warburg's tincture explained 22
B. Subcutaneous (including intramuscular) administration 22
Miscibility of Quinine salt solutions with blood-serum: coagulum formation if the Quinine
salt solution is concentrated
23
Precipitation of Quinine at the seat of injection 24
Variability in amount of Quinine eliminated in the urine. Effect of degree of concentra-
tion of the Quinine injection on elimination
25
Quinine hydrochloride solutions containing urethane, antipyrine or sodium chloride 26
Facts, (a) experimental and (b) clinical, casting doubt upon the alleged therapeutic advan-
tages of hypodermic injections of Quinine, as regards (1) amount of absorption and (2)
promptness of effect
26
Minimum-lethal dose experiments on guinea-pigs to test the relative amount of absorption
and promptness of action of Quinine after (1) oral and (2) subcutaneous administration
28
Reasons justifying the application of these results to man 33
Graphic representation (curves) of Quinine absorption after various methods of adminis-
tration
33
Local and post-mortem changes in the guinea-pigs used in the minimum-lethal dose experi-
ments
34
Quinine fundamentally unsuited for hypodermic injection 35
Dangers peculiar to Quinine when administered hypodermically 35
Intramuscular injections of Quinine 38
Intravenous injections of Quinine 38
Bacelli's solution of Quinine hydrochloride containing sodium chloride 38
Great dilution not only necessary in order to avoid the dangers noted after subcutaneous
injections of Quinine but in itself beneficial in malignant malaria by attenuating the
toxins and favouring their elimination
33

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