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Sulphate of Quinia---Its Use and Abuse.

BY R. L. MADISON, M. D., PETERSBURG, VA. Credulity is the besetting error of the age. It is this that gives to quackery its giant strength to cope with science and tamper with disease. It is this that makes each newspaper in our land teem with the praises of a thousand nostrums. It is this that makes the druggist yield bis sense of honor to the love of gain, and thus become the willing vender of each secret charm. It is this that makes the trusting invalid give his last dollar to the charlatan, who, while he helps him onward to the grave, tickles his fancy with delusive hopes. It is this that decks both ignorance and error in fascinating garb, and clothes in all the livery of truth the flaming falsehoods of the quack. This condition of things in the medical world is in a great measure attributable to the decided tendency of the age to deduce conclusions from imperfect data-to base theories upon isolated or badly connected facts—and to reason from particulars to generals, thereby reversing the true order of reasoning. Whatever is discovered to be true in a single instance is forthwith conjectured to be applicable to all analogous cases, and thus we have theory after theory in rapid succession issued forth to the world, accounting with specious though sophistical argument for all the varied phenomena of nature, the conclusions of which are alike at variance with sound reason and with common sense. This is true of all the departments of science, and medicine is by no means exempt ; for inasmuch as medical philosophy, like all other philosophy, must of necessity be based upon experiment, theorists are too apt to predicate opinions upon insufficient grounds, and to reason from analogy, by which even the most opposite doctrines can be easily made tenable. But in addition to the retardation of science by opinions too hastily conceived, there is another cause co-operating with even greater power in effecting the same result. I allude to the exclusive or indiscriminate employment of any single remedy in the cure of disease; the routinist, the “homo unius medicinæ,” is but a quack at best, who blindly and irrationally prescribes, and who trusts to Providence and the power of nature for that which ought to be accomplished by professional skill and scientific treatment. This practice of indiscriminately using a medicine without any rational indication for its exhibition, has done more to bring the whole science into disrepute, and to cast a stigma upon professional character, than all other causes combined. It is this that has created in the popular mind so powerful a prejudice against the use of calomel, and has made the current of unprofessional opinion so adverse to its administration. Every quack in the land knows well how to take advantage of public sentiment in this particular; for when he sets forth in glowing colors the wonder working power of his valuable preparations, he always concludes with the “ad captandum” argument, which he conceives must carry conviction of their efficacy home to every unbiased mind, " that his medicines contain no mercury."

This popular clamor against a remedy which stands first upon the list of the materia medica, and which, when properly and judiciously administered, constitutes one of the most efficient weapons which the physician can wield against disease, owes its origin and its present sustentation to its indiscriminate application in the cure of disease, or rather, to its not being restricted within its proper and legitimate sphere of curative action.

This brings me to the consideration of the subject which stands as the caption to the present article. The cinchona bark, from which the substance quinia is extracted, has derived its name from the countess of Chinchon, wife of the viceroy of Peru, to whom the medical world is indebted for its first introduction into Europe in 1640. It soon after fell into the hands of the Jesuits and became to that order a source of great pecuniary emolument; since which time, notwithstanding the opposition at first inspired by its extravagant price, and the violent prejudices conceived against its use, it has continued constantly to advance and steadily to maintain a highly reputable character with the profession generally; and

at present it has well nigh reached the acme of its popularity, and stands forth the crowning glory of anti-periodics. But this very popularity to which it has so deservedly attained seems destined ere long to be the means of bringing it into disrepute, by causing it to be perverted from those uses to which all past and present experience has assigned it, and by endeavoring to make it fulfill indications entirely at variance with its well known therapeutic action. No one can entertain a higher opinion of the anti-intermittent virtues of the sulphate of quinia than myself. Restricted to this sphere of action, it certainly stands without a rival. As a tonic it has both equals and superiors; but the practice of exhibiting this medicine in enormous doses as a sedative in inflammatory affections, and as an able adjuvant to the lancet, is becoming to a considerable extent fashionable with physicians, especially at the South.

This practice I consider as pernicious in the extreme; for all experience indubitably proves the sulphate of quinia to be an excitant, not only of the nervous, but also of the vascular system; the cerebral disturbance evinced by a feeling of fullness in the head, ringing, buzzing or roaring in the ears, and partial deafness, is almost invariably produced by small doses; in larger ones, in addition to the above mentioned phenomena, it has occasioned intense cephalalgia, vertigo, deafness, loss of sight, with dilated and immovable pupils, loss of speech, delirium, coma, and great prostration ; it has even proved in these large doses the obvious cause of death, by co-operating with the disease in establishing intense inflammatory action in the brain. Occasionally, when administered in certain morbid conditions of the system, it has been known to produce diminution of the heart's action. But may not this effect be justly ascribed to the intense excitement of the quinia, acting in such a manner as to obtend the nervous power of the brain and to paralyze its energies ? Everybody knows that the most powerful stimulant, when given to excess, will produce sedation, and yet no one would be rash enough to resort to such means as a cure for an inflammatory affection.

This practice, therefore, of using the sulphate of quinia in very large doses is much to be deprecated, not only because it is thus diverted from its legitimate sphere of action, but also because by this wasteful and injurious mode of administration, its price is enbanced to such a degree as to place it beyond the reach of the poorer classes in every community. For this last reason, if for no other, it becomes interesting to enquire, What is the smallest quantity upon which we may with safety rely for the arrestation of any given paroxysm? This must of course depend upon the nature of the paroxysm, the duration

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