On the poisonous properties of quinine / by William O. Baldwin ; with remarks by J. Marion Sims.

  • Baldwin, W. O. (William Owen), 1818-1886.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: On the poisonous properties of quinine / by William O. Baldwin ; with remarks by J. Marion Sims. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    did not discover that a given quantity ad- ministered in this way would produce death more certainly than when given on an empty stomach. Twenty-eight grains injected into the cavity of the abdomen in one instance, and twenty grains injected into the jugular vein in another, failed to produce death, yet these quantities produced death when given by the stomach. The post-mortem appearances were equally uniform with the symptoms before death. The most prominent and characteristic ap- pearances were the dark, fluid and deflbi - nated condition of the blood, and the con- gested state of the parenchyma of the lungs, resembling very much red hepatization. The vessels of the membranes of the brain were engorged, so also were the liver and kidneys in some instances. The mucous membrane of the stomach and bowels were vascular, and highly injected in patches. The mem- branes of the spinal cord were more or less vascular, and, in one instance, a semi-fluid coagulum of blood was found in the upper half of the theca verte'^ralis. This was pro- bably owing to the subject being very young, and the convulsions being much more violent and frequent than in any other instance. These experiments prove clearly that quin- ine is a poison, and one which may be made directly fatal to life. The symptoms which its exhibition gave rise to in the dog are al- most identically the same as those observed in the human subject, where poisoning from this substance is known to have been pro- duced. Indeed, there is not a symptom no- ticed in these experiments which has not, at one time or other, been observed in the cin- chona-poisoned human subject. The two cases of quinine poisoning reported in the commencement of this article, exhibited symptoms identical with those observed in the dog, and my experiments establish the fact that the manifestations of its poisonous ope?ation upon the dog are identical with those observed in the human subject, or, at any rate, do not differ more than they do in different instances on man and man. Its opera'ion as a poison, as well as a rem- edy, is certainly peculiar, and it seems diffi- cult to assign it to any particular class of poisons, differing in some respects from all of them. It appears to resemble in its ac- tion, more closely than any other, those of the second class of Orfila, or the class of “narcotic poisons.” It does not seem to possess any hypnotic proper'ies ; in this it differs from most of the substances included under this head. I do not mean to touch the much agitated question of the mode of its remedial operation, but desire to speak of its poisonous action only, and on this head will only add, further, that its operation seems to be principally upon the nervous system, as is demonstrated in the derange- ment of the senses of vision and hearing, and of the respiratory functions ; also in the general muscular agitation, convulsions, etc. As it has been detected in the urine there can be no doubt that it enters and mixes with the blood, and through this means exerts a direct influence upon the nervous system. In a practice of nearly forty years in the South, the greater part of that time I have employed the sulphate of quinine as a prin- cipal remedial agent, not only in malarial fevers but in our other endemic diseases. Accustomed as I have been to witness the most satisfactory results from its exhibition, and familiarized as I thought I was with the minutest impression which it was capable of making on the animal economy, I was pre- pared to believe every report in its favor, and had almost fallen into what I fear is be- coming now a popular error, that “if it does no good it will do no harm.” I say this much, by way of showing that I entertained no prejudice against it as a remedy, or even willingness that it should be found to possess poisonous properties, which might tend somewhat to circumscribe its useful applica- tion. On the contrary, I entertained a fond- ness for it not equalled by my partiality for any other remedy. Occasionally my enthu- siasm in regard to its virtues would be some- what abated, and my confidence in its innoc- uousness would be somewhat shaken when it failed to produce the results anticipated. Sometimes unlooked for symptoms would be developed under its influence ; but soon fur- ther experience would restore my former ad- miration of its sanative powers, and dispel all fear of the probability of its having ex- cited an injurious influence. Its occasional failure to meet the indications which it was designed to fulfill was attributed to negli*