14

could not be weighed. So far therefore as elimination by other channels is con-
cerned, Quinine excretion in the urine is quite a feasible gauge of absorption.

       Regarding the rate and amount of elimination of Quinine in the urine
there is commendable harmony in the results of recent investigators. After
medium doses ( e.g. one gramme) of Quinine administered by the mouth while
fasting, the average amount eliminated in the first 24 hours has been given by
Kleine²² as 21.9 per cent., by Mariani¹³ as 24.7 per cent., by Flamini²³ as 24.6
per cent., by Schmitz²¹ as 19.5 per cent., and by Giemsa and Schaumann⁵ as
25.8 per cent., and under the same conditions the average total elimination (i.e.,
the amount eliminated during the two or three days Quinine excretion lasted)
according to the same authorities is about 40 per cent. It would appear there-
fore that under these circumstances about 60 per cent. of Quinine is destroyed
in the body. That the amount of Quinine eliminated in the urine should
vary, as a rule, between fairly narrow limits when the mode of administration
and other conditions are similar is what one would expect. But even, under
such conditions, Giemsa and Schaumann,⁵ who regard the amount of Quinine
elimination in the urine as the best practical measure of the amount absorbed,
acknowledge that in particular individuals there are considerable variations
from the normal, and that even in the same individual there might be striking
variations on different days even when examination of the fæces showed that
absorption was similar on all the days. Further, even granting that under
similar conditions as regards mode of administration, state of gastro-intestinal
tract, etc., the amount of Quinine eliminated in the urine is fairly constant, it
cannot be assumed that under altered conditions the relative amounts of Quinine
eliminated in the urine will be proportional to the corresponding amounts of
Quinine absorbed. To show that such an assumption would be wrong it is only
necessary to compare the average amounts of Quinine eliminated in the urine
after intravenous administration on the one hand and intramuscular or oral on
the other. Mariani¹³ gives the following averages:—

Table III.