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ing cases both of oral and subcutaneous administration, hæmorrhagic erosions
were found in the stomach,—particularly in guinea-pigs that had survived soma
twenty hours or so after injection. One guinea-pig which had received
Quinine by the mouth was found to have had an extensive hæmorrhage in the
lower part of the large intestine. These hæmorrhages are most probably due
to engorged capillaries giving way. In typical cases, the ventricles of the heart
were found empty and pink in colour (therefore not contracted or in rigor) ;
both auricles were enormously distended with dark venous blood; and all large.
veins were engorged with blood.

Hypodermic Injections in General and those of Quinine in
Particular.

     A substance, to be suited for hypodermic injection, should satisfy the
following requirements :—

     (1) It should be capable of being easily sterilized, e.g., stand boiling.

     (2) Its solution ready for injection should be in small bulk, i.e., the sub-
stance should be very active pharmacologically and be very soluble
in water, saline or other menstruum.

     (3) It should be capable of rapid and thorough absorption, i.e., its solu-
tion in the concentration in which it is injected should be compa-
tible with serum and lymph.

     (4) It should be non-injurious to the tissues locally.

     (5) It should be non-irritating.

     Now, examining Quinine according to this standard, it is evident that one
only of these five requirements is satisfied. Quinine can be got into sufficiently
small bulk for injection, but in this concentration it cannot be absorbed rapid-
ly or thoroughly, and it is irritating and very injurious to the tissues at the
point of injection. Regarding sterilization, none of the salts of Quinine
stands heating well. Quinine is therefore fundamentally unsuited for
hypodermic use.

     Further, Quinine injections, although devoid of any therapeutic advantage
over administration by the mouth, are not infrequently attended by serious
complications, mutilation and dangers.

     (1)  Necrosis.—From the rapidity with which this occurred in the guinea-
pig experiments and from the rapid yellow discolouration of the skin, it
is practically certain that this necrosis is due to the direct action of the
Quinine, which even in a dilution of 1 in 150 kills outright all tissues
which by diffusion it reaches. Thrombosis could not possibly produce necrosis
so rapidly.

G