1899 Journal of the American Medical Association (JAMA)  
A perusal of current literature and an experience with physicians in active practice show many differences of opinion regarding the use and value of quinin in various malarial diseases. The recent war, by exposing large numbers of men to real or imaginary malaria, brought out in a striking manner many of the most common views, and the numerous articles directly and indirectly touching the subject seem to justify a somewhat dogmatic consideration of certain salient features. Why We Use Quinin in
more » ... hy We Use Quinin in Malaria.\p=m-\Itshould not be forgotten that our use of quinin is due to an accidental discovery and that the value of the drug and fairly reliable methods of administration were known long before we had any accurate knowledge of the cause of the disease or the nature of the changes produced by it in the body. As is well known, malaria is a disease that in most cases tends naturally to recovery, so far as each attack is concerned, with a tendency, almost as strong, to re¬ lapses. It might, therefore, be considered good practice to treat the patient expectantly as many treat other self-limited diseases. Without wishing to appear as ad¬ vocating such a policy in any self-limited disease, I wish to point out why we should not, as a matter of routine, in malaria. Each malarial paroxysm does harm in certain wellknown ways, and in some not so well known. Of the first it is enough to mention the destruction of red bloodcorpuscles, which, even in a seemingly mild case, may be quite extensive, and in a severe paroxysm may amount
doi:10.1001/jama.1899.92450570001002 fatcat:bicoa7hnsngcvbjewxk2bqnopq