Cinchona calisaya - Peruvian bark
"CONSTITUENTS: Quinine, Quinidine, Cinchonine, Chinchonidine, Quinamine, tannic acid; thirty-two natural and eight artificial alkaloids, resinoid, volatile oil, gum, sugar and wax.
PREPARATIONS: Extractum Cinchonae, Extract of Cinchona. Dose: one to five grains. Extractum Cinchonae Fluidum, Fluid Extract of Cinchona. Dose: ten to sixty minims. Specific Medicine Cinchona. Dose: one to thirty minims.
Therapy: In the administration of quinine as an antiperiodic, the beneficial influences are not altogether in proportion to the size of the dose. Enormous doses may abort a chill if given during its course, or during the course of the fever. They are very likely, however, to increase the nervous erethism and the temperature; whereas, if proper doses be given during the intermission, from one to three hours preceding the anticipated attack, or at the time when the temperature has reached its lowest point, small doses will accomplish positive results.
In continued fever, with a sufficiently marked remission occurring at a given time each day, or on each alternate day, the agent should be given during the remission, provided the temperature declines to a point sufficiently low to admit of a temporary restoration of the suspended secretions. This point is usually not above 100 ½ degrees. If the remission be short, a single dose may be given. As a result the temperature does not run quite as high as on the previous day, and the next remission is more marked and of longer duration. At this time, perhaps, two full doses, two hours apart, may be given. The fever is still lower and the remission so marked by the third day that the agent, in reasonable doses, may be continued through the exacerbation, the temperature at no time, probably, rising above 101 degrees and not increasing above normal after the third day. ...
In the treatment of congestive chill, and in malignant conditions of malarial origin, quinine is specific, but should be given in much larger doses, and usually with some direct stimulant and in conjunction with the use of external heat. It may be given in doses of twenty grains preceding the attack, or with stimulants during the attack. If a severe attack is fully anticipated, large doses should be repeated every two or three hours during the entire remission. As an antipyretic quinine is no longer used. It was once considered of essential importance in the reduction of high temperatures, but the conditions and character of its action were so imperfectly understood that it often did harm, and caused an increase in the temperature instead of a reduction. In the regular school the coal tar antipyretics have replaced it. With our own school it has been at no time depended upon to allay fever. As a restorative after pneumonia, where hepatization has been extensive, this agent is an important one. Two grains of the bisulphate of quinine, with one-fourth of a grain of ipecac, and perhaps the one-fourth of a grain of nux vomica, will rapidly improve the function of the nervous system and of the circulation, and as rapidly overcome the hepatization and other results of inflammatory action. The influence upon the stomach and intestinal canal, and thus upon the digestion and assimilation of food, is marked and immediate. ...
In chronic congestion of the liver, or splenitis, quinine dissolved in the tincture of the chloride of iron, and combined with syrup of orange or simple elixir, produces satisfactory results.
In the prostrating night sweats following malarial fever this agent, in the above combination, is a fine tonic, quickly overcoming the sweating and other results of the disease.
Where paludal miasm is the cause of various indefinite disorders, or of general malaise, the phenomena occurring periodically, quinine should be given to anticipate the unpleasant symptoms. Dumb ague, hemicrania and severe general headaches, neuralgias of various kinds and asthmatic attacks occur from this cause and are satisfactorily treated with this remedy. It may be afterward given as a tonic, in combination with any other tonic agent which may be specifically indicated.
Quinine has a direct power in inducing contraction of the parturient womb, especially if from inefficient strength the labor has been prolonged until the nervous force of the patient is well nigh exhausted. If fifteen grains be given in one dose, it may overcome all undesirable conditions at once and prove sufficient. The contractions are normal in frequency and of regular character and force.
It thus overcomes inertia and will prevent post-partum hemorrhage. It is a good remedy for this latter condition when it has occurred, acting also as a stimulant to the heart and nervous system. It is a dangerous remedy in large doses during pregnancy, as it may bring on premature labor.
In amenorrhea, from cold it is useful and may be prescribed alternately with aconite, after a hot bath has started secretion from the skin.
As a stimulating antiseptic it has been used as a wash in very many conditions. In sluggish ulcers and old sores, where there is no activity to the capillary circulation, it may be applied with good results. It is useful in threatened gangrene and in chilblain. It was at one time extensively used as a throat wash in diphtheria, and to its antiseptic character is credited its beneficial influence upon whooping cough, having been much depended on for the cure of that disease. ..."
(Finley Ellingwood: The American Materia Medica, Therapeutics and Pharmacognosy, 1915)