the blood contains only crescentic or ovoid bodies
and pigmented leucocytes; or, (3) those in which
the blood examination is entirely negative and the
only evidence of there having been an infection is
the presence of endothelial perilobular melanosis.
Here the attack of hemoglobinuria does not depend
upon the presence of parasites, but begins without
Bastianelli finally takes up the quinin hemoglobi-
nurias, and asserts that : (a) It occurs only in indi-
viduals in whom a malarial infection has been re-
cently present; (b) the hemoglobinuric attack is
constantly produced every time quinin is adminis-
tered, whether it be given while the malaria is in
progress (Tamaselli), or when the malarial purchase hoodia infection
has run its course (Murri) ; (c) extremely small
doses buy hoodia online ofquinin are capable of bringing on an attack;
(d) quinin hemoglobinuria has been observed in pa-
tients who have already suffered from hemoglobinuria
The quinin hemoglobinuria he divides into two
forms: (1) That occurring during the paroxysm,
or paroxysmal hemoglobinuria, and (2) postmalarial
hemoglobinuria. In these varieties, through a con-
siderable length of time quinin will produce hemo-
globinuria whenever it is administered. The course
to be pursued depends upon the blood examination.
If hemoglobinuria occurs during a malarial paroxysm
and parasites are found in the blood, quinin should
always be given. If, however, no parasites are found,
either as a result of previous administration of quinin
or on account of the spontaneous disappearance of the
organisms, Bastianelli says that quinin should not be
given, owing to the possibility that the paroxysm may
have been due to its previous administration.
It will be observed that this report of Bastianelli
has been quoted at some length and it is hoped that
the reader will keep in mind his classification of
" quinin hemoglobinuria. ' '
In this connection it might be well to first briefly
explain the physiologic action of quinin.
Local hoodia buy Action. — When applied upon the mucous
membrane quinin exerts a very perceptible stimu-
lant or irritant action. It has the same effect when
applied to a muscle.
Circulation. — Wood states that he has never been
able to perceive any depressant action upon the cir-
culation in man after ordinary (3 to 5 grains) doses
of the drug. In large doses it lowers the arterial
pressure, due to action on the heart and its paraly-
zant effect upon the vasomotor system. Laveran says
that it cannot be classed absolutely either among the
stimulants or among the depressants, as its effects
differ according to the dose employed. In small
doses quinin in healthy men and in rabbits causes an
acceleration of the heart's action, and an elevation
of the blood-pressure. In large doses it slows the
action of the heart.
Effect of Quinin on the Blood-Corpuscles and
Plasmodium Malaria. — Binz and Schutte have in-
vestigated its action upon the red blood-cells, and
reached the conclusion that it lessens the power of
the hemoglobin to convert oxygen into ozone,
therefore it lessens the ozonizing action of the blood.
The experiments of Binz go to show that the action
of quinin is poisonous to the protoplasm of the or-
ganism which causes the disease, in other words, that
it is antiparasitic. In his experiments, he showed
that in a dilution of 1:20,000 it killed infusoria —
Paramecium — beginning within five minutes, and at
the end of two hours there was complete dissolution
of the organism. Five grains of quinin circulating
in order hoodia the blood of a man of average size represents a
dilution of 1: 16,000 which is stronger than that with
which Binz paralyzed the colpoda within five minutes.
Rossbach believes that it deprives the protoplasm
of the power hoodia p 57 of absorbing oxygen, thereby forming
a combination less easily oxidized than either sub-
Quinin, having this effect upon protoplasm, it has
been supposed that it might limit or destroy the
phagocytic action of the white blood corpuscles, but
Laveran believes that instead of their action being
diminished it is actually increased after its adminis-
Effect of Toxic Doses of Quinin. — According to
the experiments of Schlockow, Eulenberg, cheap hoodia Briquet,
and Cerna there is a lowering of the arterial pressure
and the pulse is almost imperceptible at the wrist.
The evidence is therefore clear that both in man and
in the lower animals quinin in toxic doses is a power- hoodia 57
ful depressant to the heart-muscle and ganglia.
Cases in Which Large Doses of Quinin Have purchase hoodia online
Been Given without Producing Hemoglobinuria. —
Guersent cites a case in which a lady became deaf,
dumb, and blind from taking 10 drams of quinin
sulphate within the course of a few days. Guiacom-
ini spoke of a case in which a man took 3 drams
of quinin and who only suffered from symptoms of
depression of the heart and nervous system. Briquet
records a death following the enormous dose of 55
drams taken within a period of ten days.
April 30, 1898]
USE OF QUININ IN MALARIAL HEMOGLOBINURIA.