The coeliac axis being one of the greatest centres for the action of Quinine, and its branches being so abundantly supplied to the spleen, shows us at once why Cinchona has such a powerful action upon this organ. The ganglionic life of the Malpighian bodies of the spleen is destroyed through its action upon the coeliac axis, and their catalytic blood-making functions are lost. This is one cause of the anaemia we see in those who are suffering from Cinchonism.
Abdomen.–The action of Cinchona upon the intestinal canal is to produce debility, through the ganglionic nervous centres of the abdomen. Its action upon the liver and spleen, clogging their circulation, causes great venous congestion of the bowels; the stagnation of the blood in the vena porta causes ascites.
Urinary Organs.–Through the vascular system Cinchona and its alkaloid, the Sulphate of Quinine, affect prominently the urinary organs, greatly diminishing the uric acid.
Dr. Ranke tried it in three individuals in health, and found that under the influence of Quinine the uric acid was diminished nearly one-half. Dr. Hammond made a series of observations during an attack of intermittent fever, where, as in all fevers, the amount of uric acid is always greatly increased. He found in this case the quantity promptly reduced more than one-half by the action of Quinine.
Quinine may be easily detected in the urine; the solution employed by Bryant for this purpose contained, to two parts of iodine, eight of iodide of potassium and two hundred and fifty of water. He found the action of the test to correspond closely with the observable effects of the medicine upon the nervous system. After the exhibition of eight grains of Quinine in one dose, a precipitate sometimes appeared in half an hour, though more frequently at the end of two hours; after four grains, in two or three hours; after two and a half grains, if any appeared it was not till the expiration of five or six hours.
The length of time, therefore, before the appearance of Quinia, is invariably proportion to the quantity taken, and the same rule hold in relation to the period at which the effects are felt.
Another fact noticed by the same experimenter, is that the quantity of the salt of Quinia eliminated is directly proportionate to that introduced. A third, also highly interesting, is that elimination always ceases after a short time, generally little exceeding that during which the effects of the Quinia persist.
Thus, after a single dose of about three grains, the Quinia disappeared from the urine in from twenty to twenty-four hours; after thirty grains taken during twelve hours, in about forty hours; and after large doses, taken for several days, in from sixty to eighty hours. This beautifully illustrates to us that the action of Quinine is not through any chemical combination with the tissues, but that it is through its spiritual medicinal principle upon the vital organ.
Under the action of Quinine the urine becomes scanty and turbid, depositing a brick-dust sediment; it also sometimes deposits a whitish sediment.
Sexual Organs.–The powerful and specific action of Cinchona and its alkaloid, the Sulphate of Quinine, upon the organs of special sense located in the cerebellum, shows us at once why Cinchona is so useful in diseases of the generative organs.
Although we do not know for certain, just the exact location of the organ of special sense that controls the sexual functions, we are certain that its location is in the cerebellum. Cinchona affects the whole nervous life of the cerebellum, debilitating and prostrating its functions, consequently affects specifically the organ of special sense hat controls the sexual functions. I also believe that some portion of the medulla oblongata has something to do with the sexual appetite. The regulation of the motor functions is certainly presided over and controlled by the cerebellum, and it may be that debility of this function, so prominently produced by Cinchona, explains in a great measure its great action upon the sexual organs, for it is in diseases where debility of the motor nervous system is so prominent that China is especially called for.
Of course we must keep constantly in our mind the fact that debility of the ganglionic nutritive fibres is one of the great effects of Quinine.
Respiratory Organs.–The action of Cinchona upon the respiratory organs is not of a specific character. No particular pathological changes are produced in these organs, excepting debility of the ganglionic nervous centres which preside over their nutrition. The long-lasting hemorrhages of the lungs, and profuse suppurations, through its action on the ganglionic nervous system, it becomes one of the most useful remedies in the Materia Medica.
Back.–Cinchona causes anaemia and debility of the muscles of the back, in this way causing neuralgia, and myalgia of the muscles of the back.
Extremities.–Upon the extremities Cinchona produces debility of the muscles, myalgia and intermittent rheumatic neuralgia. Full doses of Quinine produce complete prostration of the motor nervous system, similar to Gelsemium and veratrum viride; but it takes but a small quantity of the two last-named remedies to produce profound prostration of the muscular system, while it takes immense quantities of Quinine to get this great prostration.
The effects of Quinine are more lasting (chronic in nature), the prostration of the muscular system being caused by anaemia of the blood from prostration of the vegetative nervous system; while Gelseminum and Veratrum viride act directly upon the motor nervous system, producing great prostration of the muscular system, but soon pass away, leaving no bad results. The long- lasting bad effects of Cinchona are beautifully shown in Cinchonism (Quinine poisoning).
Skin.–In the Quinine factories of France, it seems that an acne-like eruption is one of the most common effects of exposure to the Cinchona dust, and it is so clearly recognized that some workmen are obliged to abandon the business on account of its persistence. It appears in the form of an acne-like, itching eruption, principally upon the thighs, scrotum, &c., though often over the whole body, exuding a sero-pus, and finally forming scabs. When the suppuration attacks the face, it occasions great swelling of the head, face, and eyelids (similar to the effects of the poison of the Rhus), and the sufferings of the patient are often very acute, especially when it attacks the genital organs. It makes its appearance very shortly after exposure to the poison, and disappears upon the removal from its influence.
Cinchona and its alkaloid have often cured moist gangrene of the scrotum and vulva. The above effects show that it has a special action upon those parts. From the prostration and decay of the productive system, ulcers may be produced upon the skin.
Quinine has often cured such ulcers.
Quinine produces anasarca by its action upon the liver and spleen, checking the portal circulation.
Blood.–In the Dublin Quarterly, for August 1856, Dr. S.
Garden has shown that Quinine defibrinates the blood, rendering it fluid and uncoagulable; this is brought about from prostration of its ganglionic neuropathic element of nutritive force that presides over composition and decomposition. There are other changes it produces in the blood, but as yet its haematic action is not fully understood.
In anaemia and chlorosis, where they have been caused from loss of vital fluids, and debility of the muscular system in the most prominent symptom, Cinchona, or its alkaloid, will be found the remedy par excellence.
In various blood diseases, Cinchona and its alkaloid will often be indicated where debility of the muscular system is long- lasting and prominent.
Fever.–Fever is the effect of specific agents being carried by the circulatory system to those structures of the body for which they have a special affinity, where they constantly emit, or give off, their toxic principle; affecting, first, the ganglionic nervous system; second, the circulatory system; third, those organs that constitute the system of secretion and excretion. Dr. Smith says: The chain of diseased organs consists of the brain and spinal cord; the heart arteries, especially their capillary extremities; the secreting and excreting organs, which in fact, are composed essentially of the capillary extremities of the arteries; the secreting and excreting extremities of these arteries, especially as they terminate in the external skin, and in the mucous membranes which form the internal skin.
There never was a case of fever in which all these organs and function were not more or less in a disordered state; and this complete circle of organs was never in this morbid state without fever. A deviation from a healthy state in one or two circles will not produce fever; there must be deviation in the three circles before ever can exist.
Every fever remedy must act upon the nervous system, and especially upon the vasa-motor part of it. In our study of Cinchona we have found that its centre of action is upon the base of the brain, and the ganglionic nervous centres that control the functions of organic life.
(1836-1897)
Characteristic materia medica Published 1873
Physiological materia medica, containing all that is known of the physiological action of our remedies; together with their characteristic indications and pharmacology. Published 1881