Case of Gastrotomy

1845 Boston Medical and Surgical Journal  
patic derangements ' and ' congested livers.' Nor do I extend to them a greater share of confidence when they are reported in connection with the use of quinine, and asserted to exist as a pretty constant cause, or part, of dysentery. These notions are so much opposed to my own observations, and savor so strongly of the theories prevalent some fifteen or twenty years ago, that 1 cannot but receive them with many grains of allowance." With regard lo the modus opcrandi of quinine, the evidence of
more » ... ne, the evidence of Dr. B. is necessarily of a negative character. Though classed among " tonics " by writers on the materia medica, the idea that its action depends upon tonic or stimulating properties, is a peculiarly unhappy one, for it has prevented its use, no doubt, in many a case of malarial fever which it would have cured with certainty ; fever, it is reasoned, is a stbenic condition of the system, and a tonic or stimulant would certainly be inadmissible in it, according to the rules of art. The terms tonic, stimulant, or sedative, convey no just impression effects of quinine ; its whole force is expended upon the nervous system, and its influence over the circulation is doubtful and uncertain. The effects perceived are those of an anti-periodic, or in more comprehensive phrase, a direct antidote to the malarial poison. How this effect is produced, is a question which must remain unanswered. The ultimate action of medicines, like most ultimate causes, thus far lies buried in obscurity, and it is better for us to be aware of our ignorance of the modus agendi of quinine, and to be content to use it for the well-known effects which experience has taught us it will produce, than to call it a tonic, stimulant or sedative, terms which involve a false theory, and must lead to erroneous practice.
doi:10.1056/nejm184507230322502 fatcat:dvx3vhyz4jbfdnnapuoi4xqqze