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in the flanks give protection from malaria for at least a month. According to
Megaw,¹⁵the temperature of malarial patients takes about twelve hours longer in
coming to normal when treated by the hypodermic method than when Quinine
is given by the mouth; from this it is assumed absorption is slower from the
subcutaneous tissues than from the mucous membrane of the gastro-intestinal
tract. Scott¹⁶has come to the conclusion that the hypodermic (intramuscular)
mode of administration of Quinine has no special value in the treatment of
acute cases of malarial fever owing to slowness of absorption. The results
obtained by Cohen³⁷are interesting from two points of view: they show the
conclusions arrived at by an advocate of Quinine injections, and they were
obtained by the use of Quinine urea which was so strongly recommended by
Giemsa and Schaumann. Cohen states that 15 grains of Quinine urea, if
injected during or within four hours after a paroxysm of malarial fever, were
readily absorbed and procured freedom from fever for a period of from six to
thirteen days: he, however, admits that Quinine by the mouth is "equally
efficacious". His statements that the Quinine urea was readily absorbed from
the point of injection and that freedom from fever was obtained for from six to
thirteen days are hardly consistent.

     The evidence, so far, casting doubt upon the alleged therapeutic value of
the subcutaneous administration of Quinine can be summarised as follows:—

I.—ABSORPTION.

     (1)  Experimental.—The behaviour of Quinine solutions when mixed with
ox blood-serum suggest the possibility of very dilute solutions of Quinine (1—150)
but the unlikelihood of concentrated solutions, such as ordinary Quinine hypo-
dermic injections, being readily absorbed: it suggests the probability that most
of the Quinine in hypodermic injections is thrown out of solution at the point
of injection, is combined with albumen in an oxidised but unstable form and is
gradually liberated from this combination.

     Mariani's¹³experiment, in which he recovered from rabbit's muscle 66.5
per cent. of the dose of Quinine (Quinine hi-hydrochloride 1 in 5) injected 17
hours before the rabbit was killed, is positive proof that Quinine was deposited
at the point of injection, and that most of the Quinine was still lying at the
point of injection 17 hours after the injection was made.

     The experiments on Quinine elimination in the urine give very little
information regarding Quinine absorption. One point which seems to be
definitely settled is that the amount of Quinine eliminated in the urine after
hypodermic injection is invariably less than that after oral administration. By

F