How to use quinin and urea hydrochlorid : especially for systemic effect by injection in malaria and pneumonia / Solomon Solis Cohen.

  • Solis-Cohen, Solomon, 1857-1948.
Date:
1912
Catalogue details

Licence: In copyright

Credit: How to use quinin and urea hydrochlorid : especially for systemic effect by injection in malaria and pneumonia / Solomon Solis Cohen. 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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    CHLORID; ESPECIALLY FOR SYSTEMIC EFFECT BY INJECTION IN MALARIA AND PNEUMONIA. Solomon Solis Cohen, M. D. Professor of Clinical Medicine in Jefferson Medical College. Philadelphia. Quinin and urea hydrochlorid—long known in Germany as chininum bimuriaticum carbamidatum and used with confidence by some American physicians, most of whom learned of it a generation ago from Professor Roberts Bartholow, or more recently from his pupils~has within a few years come into prominence as a local anesthetic. Of its use as such, I do not now wish to speak, except to call attention to its great value in acute tonsilitis and in tuberculosis of the larynx. A solu» tion of 1:10 or less is usually strong enough, but even a 20 to 50 per cent, solution may be employed if necessary. It can be applied by spray, sponge, brush, cotton applicator, etc., as may be most feasible in the individual instance. Sometimes the patient may simply take a teaspoonful or two of the solution in his mouth and holding it back toward the painful region of the tonsils or epiglottis, move it gently to and fro by action of the pharyngeal muscles. This is somewhat easier than garg»» ling, and gives more relief. Done 10 minutes before the taking of food, it will sometimes permit nourishment to be given in cases of ulceration of the epiglottis or other painful tubercu- lous lesion in which all other methods of relief have proved! unavailing. Neither in tuberculosis nor in tonsilitis need the patient be apprehensive of any danger from swallowing the solution, as a dose of 5 grains or so, three times a day, would not ordi- narily be hurtful, and in febrile cases might be beneficial. Sometimes, indeed, the specific direction to swallow a part of the solution—or even all of it—is given. It is, however, more particularly with the systemic effect of the drug and its administration in malaria and in pneumonia that this note deals. I have received many inquiries concern- ing particular details of the method of administration employed by me in the treatment of acute lobar pneumonia and acute lobular pneumonia by massive doses of q^uinin and urea hydro- chlorid—the favorable influence of which I reported some months ago to the Association of American Physicians {Am. Jour. Med. Set., Jan., 1912, p. 40)-—and this is the easiest method of answering at once all my correspondents. The drug may, of course, be given by the mouth in solu- tion, powder or capsule, as any other salt of the cinchona alkaloid. It is probably more active, grain for grain, than any other quinin preparation. Possibly the urea is a linking body;