ON THE USE 
OF 
SULPHATE OF CINCHONIDIA 
IN PARTS OF THE STATES OF 
ILLINOIS, INDIANA, MISSOURI, KENTUCKY, 
AND IN THE MISSISSIPPI VALLEY, 
I IN 1 8 r £5 . 
From Medical Journals, Societies, and Individual Physicians. 
PHILADELPHIA: 
JAMES A. MOORE, PRINTER, Nos. 1222 and 1224 SANSOM STREET. 
1876. THE CHEAPER 
CINCHONA ALKALOIDS. 
From Jas. S. Whitmire, m. d., Metamora, Ill., in the Chicago Medical Jour- 
nal, August, 1875. 
For several years we have been convinced that it would 
be to the material interest of the medical profession, 
everywhere, to pay more attention than has heretofore 
been done to the use of the cheaper cinchona alkaloids, 
and this should be the case, more especially, with that 
portion of the profession who reside in the rural districts 
and country villages, where they are compelled, almost 
from necessity, to furnish their own medicines. There 
are several reasons why this should be done, among which 
is the well-known fact that the forests of the different 
valuable species of the cinchona tree are becoming greatly 
decimated; and though there is still an abundance of the 
bark for the world's supply, yet the time is not far distant 
when the States of South America, where the tree is indi- 
genous, will institute measures for its preservation, and 
this 'will necessarily shorten the supply of the bark. We 
understand that such measures have already been insti- 
tuted in Chili and Bolivia. It is true that the Dutch in 
Java, and the English in the East and West Indies, have 
been successful in acclimatizing some of the most valuable 
species of the cinchona tree, and have already begun to 
make the bark from their plantations a commodity of 
commerce; yet, with the wholesale destruction of the 
tree in its native mountain wilds, for the procuration of 
the bark for the purposes of commerce, it must, sooner 
or later, be decimated to the minimum amount, so that 
the supply will necessarily cease to be equal to the 
demand. This may not prove to be the ultimate result in 
our day, but we, the profession, who claim to be humani- 
tarians, should look with a jealous eye, not only to our 4 
own pecuniary interests and physical well-being, but the 
welfare of those who are to come after us, and fill our 
places for a brief period, should be kept constantly in 
view. Another reason why we should pay more attention 
to the use of the cheaper alkaloids, is that either or all 
of them are relatively cheaper than quinia, even though 
two of them have to be used in larger doses than the 
latter drug to accomplish the same results; besides, so far 
as our experience has been connected with their uses, we 
have not the least question of their utility as a substitute 
for quinine under nearly all circumstances where the use 
of the latter drug is indicated. 
With the above prefatory remarks, we now desire to 
state that we have used all of them, excepting cinchoni- 
dine, in our practice for several years. We first used 
sulph. of cinchonia, next sulph. quinidia, and third, the 
sulph. of cinchonidia; and even the residue-chinoidine- 
which is evaporated to dryness from the mother-waters 
after the crystallizable salts have been separated, has been 
utilized in our practice, as a prophylactic against the re- 
currence of intermittents. We seldom make use of the 
sulph. cinchonia-which we have used for the longest 
period-as an antiperiodic, or antipyretic, because of its 
tendency to nauseate the stomach; but, nevertheless, we 
are convinced that it possesses valuable febrifugal and 
antiperiodic properties, and may be advantageously util- 
ized for such purposes in the absence of either of the 
other preparations of the bark. Notwithstanding its nau- 
seating qualities, we usually make it available as a general 
tonic in connection with the mur. tinct. of iron, especially 
at times when a chalybeate is indicated-a condition 
which is seldom absent after an attack of intermittent or 
autumnal fever; and we find it to be, to the full, as effi- 
cient in this respect as quinia, or any of the bitter tonics; 
besides, it has the advantage of acting as a prophylactic 
against the recurrence of a chill. Our usual prescription, 
under the circumstances just mentioned, is this :- 
B. Cinchon. sulph., 
Ferri, mnr, tinct., 
Sj 
Syrup simp., 
Sig. One teaspoonful, in water, at each meal. 5 
This is an admirable tonic, and may be used with advan- 
tage in anaemia and other debilitated conditions. The 
sulph. of cinchonia, in bulk, costs about thirty-five cents 
per ounce. 
The sulph. of quinidia we have used to a greater or less 
extent in our intermittent and remittent bilious fevers 
ever since it was first thrown upon the market. This 
alkaloid, though, in fact, but little cheaper than quinine, 
we have found equally efficacious as an antiperiodic and 
antipyretic as the quinia sulph., though it must be used in 
a little larger dose than the latter drug. As an evidence 
of its value in some of the periodical neuroses, such as 
that commonly known as sun-pain, we have frequently 
administered it with as prompt relief to our suffering pa- 
tients as we have ever known to be produced from the 
use of our sheet-anchor-quinine. As an example, my 
wife for many years has been subject to this distressing 
intermittent or periodical neuralgia; she was greatly op- 
posed to taking quinine on account of the tinnitus aurium 
and other distressing symptoms it produced. Now, under 
these circumstances, while twenty-five to thirty grains of 
quinine may have been sufficient to interrupt the par- 
oxysms of pain, I administered to her forty grains of the 
quinidia sulph. in the course of twelve hours, which com- 
pletely warded off the attack, and did not subject her to 
the disagreeable after-effects to that extent that the use of 
quinia is wont to do. This drug (quinidia) costs in the 
market about $1.63 per ounce, but the dose required 
being nearly or quite one-fourth larger to produce the 
same febrifugal effect as that of quinia, it makes the ex- 
pense but very little less than the latter drug. But if its 
febrifugal and other qualities be equivalent to that of qui- 
nine in proportional doses, why not use it more extensively, 
especially in our milder malarial fevers, so that the 
demand for quinia will not be so great, thus cheapening 
the article of quinine, and, at the same time, preventing 
the wholesale destruction of the bark that has been going 
on for years for the production of a sufficiency of quinine 
to supply the world's demand ? 
The last of the alkaloids-sulph. of cinchonidia- 6 
though not the least, comes up for our consideration. This 
article has not been so long upon the market as the latter 
alkaloid; in fact, it has not till within a few months been 
brought more than casually to the notice of the profession; 
but because its introduction has been of but recent date there 
is no reason why those who have seen fit to test its medi- 
cinal virtues, and give it a fair and impartial trial, should 
be treated so cavalierly when they attempt to call the 
attention of the profession to its value as a remedial agent. 
It is our object in this paper to call the attention, espe- 
cially, of country practitioners to the unqualified value 
and merits of this drug as atonic, febrifuge, and antipe- 
riodic. So far as our experience has gone with the use of 
this alkaloid-cinchonidia sulph.-we are disposed to 
attribute to it very nearly, if not quite, an equivalent 
therapeutic value with that of the sulphate of quinine. 
We have used it in the same doses-ten to twenty-five 
grains-with complete success, in interrupting the par- 
oxysm of intermittents; we have administered it, in con- 
nection with morphia, to dispel the malarial complications 
that sometimes occur in pneumonia, with satisfactory 
results; and, in acute rheumatism, we have substituted it 
for quinia, whenever the latter drug seemed to be indi- 
cated, with unequivocal benefit. We have had this spring 
(1875) in this vicinity more than a usual amount of mala- 
rial or periodical diarrhoea and neuralgia, both among 
children and adults, for the relief of which we have been 
in the habit of prescribing the sulph. cinchonidia, with 
other appropriate remedies. In these cases the same 
amount was given as that of sulph. quinia under similar 
circumstances-we seldom or never had to repeat the 
dose-and its administration was attended with the most 
complete and satisfactory results. 
This article-cinchonidia sulph.-can be obtained by 
the quantity for from seventy-five to eighty cents per 
ounce, and, therefore, we would respectfully ask the 
question: If the value of this agent as a tonic and febri- 
fuge is equivalent, or nearly so, to that of quin, sulph., and 
its commercial value is only one-third of the latter, is it of 
no concern to the country practitioner, who has to furnish, 7 
at great expense, annually, his own drugs, not only to 
the wealthy, but to the indigent from whom he never ex- 
pects to receive one farthing for his services, and for whom 
he labors solely for the sake of suffering humanity, for 
the answer of a good conscience, and the gratitude of his 
beneficiaries ? 
We would not use these cheaper remedies merely for 
mercenary motives; no one could conscientiously do so; 
but we would, and do, prescribe and use them because we 
believe them, in equivalent doses, to be of the same ther- 
apeutic value as that of quinia, and that they may be 
safely used as a substitute for it; and, in so doing, we are 
treating our patients well, and, in not a few instances, we 
are not only contributing our medicine and our services 
to the poor, but we are rendering good service to the 
general health and comfort of our patients, and saving to 
ourselves the difference in the cost of the drug used, which 
would amount to no mean sum in the course of the year, 
and which the country physician so much needs, because, 
at best, his life is a hard one, and few there are, indeed, 
who make any more than enough, from year to year, for 
the economical support of themselves and families. 
Chinoidine, the residual product of the mother-waters, 
we have used for more than twenty years as a prophylac- 
tic against the recurrence of intermittents. The most 
eligible form in which we have been able to prepare it for 
use, is to finely powder the resin, and then add a sufficient 
quantity of calcined magnesia to prevent the powdered 
resin from running together, then thoroughly rub them 
in a mortar, and afterward bottle. Of this powder we 
give from three to four grains, after each meal, for one 
day; on the next, we administer ten drops of Fowler's 
solution, in water, after each meal; and so continue alter- 
nating the medicines for four or five weeks, when every 
vestige of malarial influence will be found to have van- 
ished. Of course, we always first interrupt the paroxysms 
by the use of one or the other of the salts of the cinchona 
alkaloids. 
In case these directions are strictly carried out, there 
will not be three per cent, of relapses, while there are 8 
more than thirty per cent, where the prophylaxis is not 
used. Chinoidine, used in this manner, is by no means a 
disagreeable medicine, because it is but slightly soluble in 
either saliva or water; hence it may be given in syrup to 
children with but little or no complaint. 
From the St. Louis Medical and Surgical Journal, September, 1875. 
Extract from the Minutes of the Allen County, Indiana, Medi- 
cal Society, on the Use of Sulphate of Cinchonidia. 
A spirited discussion on this subject was participated in 
by Drs. J. R. Beck, Jas. S. Gregg, D. S. Linvill, G. S. 
Brueback, and C. Sihler, during the course of which seve- 
ral of the gentlemen spoke in most favorable terms of 
their experience with sulphate of cinchonidia, and all 
agreed that the investigation of the merits of the drug 
was important. 
From the Indiana Journal of Medicine, September, 1875. 
Extract from the Minutes of the Wabash County Medical 
Society, on the Use of Sulphate of Cinchonidia. 
The subject was taken up and discussed by the mem- 
bers, who gave a very favorable report of the sulphate of 
cinchonidia. So far as they had used the medicine it had 
answered equally the purpose of quinine in intermittent 
fevers, etc., and in some instances, where there was an 
idiosyncrasy against quinine, it acted much better. 
From the American Practitioner, October, 1875. 
Dr. Theophilus Parvin, in Notes of Practice at the 
Indiana Reformatory for Women and Girls, writes as fol- 
lows :- 
SULPHATE OF CINCHONIDIA IN INTERMITTENT FEVER. 
Nearly two months ago I commenced the use of sul- 
phate of cinchonidia. It was administered in a solution* 
* Since writing the above, some three weeks ago, many new cases of inter- 
mittent have occurred at the Reformatory, and they have been characterized 
by greater gastric disturbance and greater obstinacy to the action of remedies. 
For the former reason I have replaced the solution mentioned by pills of the 
sulphate of cinchonidia, tartaric acid, and water (this is an admirable way oi 9 
made by adding to one ounce of the salt two fluid ounces 
of aromatic sulphuric acid, and fourteen fluid ounces of 
water. A teaspoonful, or one fluid drachm, of this solu- 
tion would therefore represent three and three-quarter 
grains of the sulphate. 
The number of cases of intermittent fever treated with 
this preparation was twenty-four-two quotidians, one 
quartan and the rest tertians. Immediately upon the 
manifestation of the disease two teaspoonfuls of the solu- 
tion previously mentioned were given, and continued 
three times-adults four times-a day for three days; 
then, in order to prevent a relapse, two teaspoonfuls twice 
a day for one month. In no instance did it fail to 
promptly arrest the disease, and in no case has there been 
a recurrence, save when there was a failure to take the 
remedy as directed. In a case of Wood's pernicious fever, 
I did not think it right to risk the cinchonidia, but gave 
quinia; nor have I yet tried it in malarial neuralgia, hav- 
ing had such long-established confidence in the value of 
quinia, with morphine and the English extract of bella- 
donna, in this disorder; but, with these exceptions, the 
sulphate of cinchonidia is almost the sole reliance as an 
antiperiodic in my practice at the Reformatory. 
From the St. Louis Medical and Surgical Journal. 
St. Louis, Mo., November 15th, 1875. 
Mr. Editor :-In answer to your inquiries, there were 
treated at the City Dispensary, from August 13th to 
November 3d, seventeen hundred and eighty-eight cases of 
malarial disease; of this number, five hundred and ninety- 
six took sulphate of cinchonidia, instead of sulphate of 
quinine. The quantity given was the same that we give 
of quinine. It was quite as efficient, and in some cases I 
thought more efficient than quinine. 
I have tested it, I think, pretty thoroughly. The con- 
dition upon which the patients receive their medicine, 
making pills); and, for the latter, I have given the sulphate in larger doses; 
in one instance, forty grains within twelve hours. The general result has 
been still quite satisfactory. In the few instances where the remedy failed to 
arrest the disease, it was not given in sufficient quantity, or was rejected by 
vomiting. 
2 10 
after proving their poverty, was, that they report to me, 
promptly and regularly, their progress. 
They did thus report, and the results and facts thus 
obtained were convincing to me. My usual plan of treat- 
ing the cases was as follows:- 
If the bowels were not already in a soluble condition, 
they were rendered so by a free use of sulphate of mag- 
nesia. Sulphate of cinchonidia was then administered 
(even though the fever had not yet disappeared), in five 
to eight-gram doses, every two or three hours, until forty 
grains had been taken, then continued in two-grain doses, 
every three hoprs, until twenty grains had been thus used; 
it was then discpptinued until the seventh day from the day 
of the last paroxysm, when it was again resumed, two 
grains every three hours during the day. This resump- 
tion on the seventh ,day was repeated as far as the fourth 
seventh day; on the intervening days a pill was given, 
compounded as follows:- 
B. Sulphate of cinchonidia, 
gr-j 
Ferri, pulv. (per hydrogen), 
gr-j 
Strych. sulph., 
gr-A 
Acid arsenious, 
gr-Tff* 
Out of the five hundred and ninety-six cases, there were 
six cases of failure on the part of the cinchonidia to break 
and prevent the paroxysms. These I attributed to the 
patients failing to follow instructions. (This report does 
not include imbeciles and dead-beats, to the number of about 
thirty; wherein there was failure, the cause of failure was 
too palpable.) About fifteen relapses occurred at the end of 
the third or fourth week; some of these were dependent, 
I thought, upon leaving oft* the medicine too soon. We 
have, then, I think, in sulphate of cinchonidia a substitute 
for quinine, cheap, efficient, and easy of administration, 
not followed by the disagreeable tinnitus aurium peculiar 
to quinine. Yours, truly, 
J. IT. Love, m. d., 
Dispensary Physician. 
From the St. Louis Medical and Surgical Journal. 
Cinchonidia is one of the alkaloids of cinchona. We 
have used its sulphate, with success, in this asylum, as a 
substitute for quinine. 11 
It has been given in a large number of malarial affec- 
tions, and in no case has it failed to do all that could have 
been expected of quinine. We have used in the last 
seven months thirty-five ounces of sulphate of quinine,' 
thirty-four ounces cincho-quinine, and forty ounces of sul- 
phate of cinchonidia. 
I have tabulated, from the records, 100 cases of inter- 
mittent fever which were treated with cinchonidia. The 
average length of treatment was 4.3 days; the average 
amount taken, 83.7 grains, or at the rate of 19.5 grains a 
day. 
The general plan pursued was to give a mild purgative, 
and follow it with ten or fifteen grains of the cinchonidia, 
with a malarial pill twice a day. Very few had the second 
chill, but the treatment was continued for several days as 
a precautionary measure. In some of the weakef patients 
it was followed by tonics. There were only two or three 
relapses. The drug was generally well borne by the 
stomach. 
Observation of its effects has tended strongly to con- 
vince me that, while fully as effectual as quinine, it is 
much more gentle in its action, rarely producing the tin- 
nitus aurium, deafness, roaring in the head, etc., etc., 
which make the latter drug so obnoxious to many patients. 
As the statements of the insane cannot always be relied 
on, I am not in a position to speak positively on this point. 
I have myself taken fifty grains in two days, without 
any head symptoms whatever. On me its effect is simply 
charming. I shall never take another grain of quinine if 
cinchonidia be procurable. 
The malarial pill spoken of above is made according 
to the following formula: 
R. Mass, hydrarg., 
Piperine, aa 
grs.cc 
Cinchonidiae, sulph., 
388 
Ammoniae carbazotatis, 
Podophyllin, 
grs.xv 
Atropiae sulphatis, 
gr-j 
01. piperis nigri, 
q. s. ut. 
Ft. mass. div. in pil. No. cc. 
Sig. Two to five a day. 12 
The only novelty claimed in this pill is the use of atro- 
pia. I was first led to employ it as an anti-malarial agent 
by observing the analogy between the pathological condi- 
tions in some varieties of congestive chill and cholera. I 
had used it successfully, following the example of my 
friend Dr. Hodgen, in the latter disease, and in cholera- 
morbus, and concluded that it might be efficacious in the 
former. This proved to be the case. I then succeeded 
in stopping a " shaking ague" in a few minutes by a hy- 
podermic injection of, if my memory serves me right, 
grain of sulphate. Thus encouraged, I began to use it 
internally in the treatment of intermittents, and thus far 
have found it a valuable adjunct to other remedies. These 
pills, when given one every four, five, or six hours, are 
often alone sufficient in mild cases. 
The utmost care should of course be taken to secure 
the accurate division of the atropia. 
The one two-hundredths of a grain contained in each 
pill, may appear to some a homoeopathic dose, but if they 
will try a few doses, a couple of hours apart, their opin- 
ions will probably undergo a change. 
The cinchonidia has proved valuable as a tonic, effica- 
cious in certain forms of neuralgia and rheumatism, and 
a good sedative in some cases of mania and melancholia. 
We have also used the sulphites of soda and magnesia, 
and the tincture of eucalyptus globulus, in the treatment 
of intermittents. The sulphites acted well in quite a 
number of cases, but failed entirely in several others, 
which were immediately relieved by the cinchonidia. The 
eucalyptus is still on trial. 
The sulphate of cinchonidia can be bought for a little 
more than one-third the price of the sulph. of quinine. 
That used by us was made by Powers & Weightman, of 
Philadelphia. N. D. V. Howard, m. d. 
St. Louis County Insane Asylum, Nov. 1, 1875. 
Extract from a letter of Dr. F. B. Einsen Bockius, Medical Director of the 
North Star Dispensary, Chicago, 111., October, 1875. 
In a public charitable medical institution which, like 
the North Star, treats annually from 10,000 to 14,000 pa- 13 
tients, it is obvious that the cases in which a remedy of 
this nature is demanded are very numerous, and the 
opportunity for investigation almost unlimited. Though 
but a few months have elapsed since I commenced its 
trial, the instances of its employment have grown into 
hundreds. 
As the result of experiments upon the lower animals, 
in which a fatal effect had been produced by cinchonidia, 
I found but one common and constant pathological 
change, viz.: intense congestion of the anterior portion 
of the cerebral hemispheres. In this peculiarity your 
alkaloid resembles cinchonia, and differs from quinia, 
which causes hypersemia of the investing membranes, and 
frequently injection of the brain tissue itself. 
My attention has been especially directed to the thera- 
peutical application of cinchonidia in its administration 
as tonic, antiperiodic and alterative, with the annexed re- 
sults. 
As Tonic. In cases of impaired digestion-except 
when accompanying great general debility or nervous 
prostration-it ranks equal with quinia, while in disor- 
dered alimentation, co-existing with cerebral or arterial 
excitement, cinchonidia is vastly the superior of that 
derivation. Your remedy is less apt to create gastric irri- 
tation, and is more readily borne by children. 
As Antiperiodic. In recent intermittent and remit- 
tent fevers it has surprised me by the rapidity, certainty, 
and ease with which it arrests the paroxysms, and, as 
well, by the almost total absence of unpleasant effects 
upon the sensorium, such as are often urged as a valid 
objection to the employment of quinia. In malignant 
remittent (congestive chill) I have not had occasion to test 
it, but do not doubt its efficacy. When, however, we 
have to deal with old or chronic cases of periodic fevers, 
the remedy has proven at my hands less energetic in gain- 
ing control of the disease than quinia, although it affords 
a much surer immunity from a return of the disorder. 
As Alterative. I am fully persuaded that cinchoni- 
dia possesses, in a marked degree, a hitherto unnoticed 
property as an alterative. My attention having been 14 
pointedly attracted by the rapid improvement of chronic 
(probably tinctured with specific poison) ulcers, affecting 
patients who were under treatment for ague (and upon 
whom quinia and iron had been used without mitigation 
of the local malady), directly the system was brought under 
the influence of cinchonidia, administered in antiperiodic 
doses, repeated experiments always affording the same 
results, I am compelled to admit to the alkaloid a medici- 
nal virtue very similar to that possessed by " equatoria 
garciana " (when the Bliss & Kean fluid extract is deprived 
of its iodide of potassium and bichloride of mercury), 
that is, a tonic alterative, differing from colchicum and 
the minerals in the fact that it maintains and increases 
the tone of the system while it exerts its power as an 
alterative. 
The conclusions I draw from my experience with cin- 
chonidia are somewhat as follows: It is tonic, antiperi- 
odic, and alterative; it is less (than quinia) a local irritant, 
either when applied externally or administered by the 
mouth, and also disturbs less injuriously the functions of 
the various organs of the body; if taken in poisonous 
quantities, it causes congestion of the anterior lobe of the 
cerebrum, which may possibly be urged to inflammation; 
in cerebral, arterial or inflammatory excitement it is pre- 
ferable to quinia (when, of course, either is indicated), as 
it affords a more perfect security from relapse than its 
rival, and, while less rapidly energetic, it maintains its 
influence for a greater period of time. 
In private practice I employ cinchonidia as frequently 
as quinia, while for Dispensary uses I greatly prefer the 
former, both on account of its reduced price (which is 
always an object with charitable institutions), and because 
of the permanence of its effects. 
North Star Dispensary is employing cinchonidia almost 
exclusively, and if the preparation proves itself as useful 
in the future as in the past, we will not soon discard it. 
From Dr. Philip Adolphus, of Chicago. 
The gentlemen of the medical staff of the Central 
Free Dispensary of West Chicago have, for the past three 15 
months, been using sulph. of cinchonidine to the exclu- 
sion of quinine. 
They are satisfied with its antiperiodic and tonic 
powers. 
Sulph. of cinchonidia will in future be used in this In- 
stitution as a substitute for quinine. 
Dr. M. M. Van Ness, Decatur, Indiana. 
It is with the greatest gratification, after a continued 
test in every case where I have heretofore employed 
quinine, that I commend the use of cinchonidia. In 
ague, I think it far preferable. In over five hundred 
cases, during the past sixty days, I have administered it in 
doses of from fifteen to forty grains, and have never had 
a recurrence of the disease. I have no further use for 
quinia, and am certain, where it is fairly tried, it will super- 
sede all other bark preparations. 
From Dr. F. S. C. Grayston, Huntington, Indiana. 
I have prescribed some fifty ounces of cinchonidia for 
the various malarial diseases incident to this climate, and 
■with satisfactory results. I believe in almost every case 
its effects were as prompt and reliable as generally attend 
the exhibition of sulphate of quinia. It is undoubtedly a 
valuable addition to our Materia Medica. 
I have prescribed the cinchonidia in somewhat larger 
doses than that of quinia, and have noticed a less disposi- 
tion to the return of agues under its influence than has 
been my experience with the sulphate. 
Dr. N. de V. Howard, St. Louis County Insane Asylum. 
We have used during the past six months over fifty 
ounces (of sulphate of cinchonidia), and find it equally as 
efficacious as quinine. 
Dr. T. J. Griffith, Darlington, Indiana, August 22,1875. 
I assure you that sulphate of cinchonidia is a new thing 
with me. I began using it in 1874, along with quinia, 
and find it equally as reliable as an antiperiodic. During 
the present year, I have not used any quinia in my prac- 16 
tice. For the country practitioner, who dispenses his own 
medicines, in the use of cinchonidia there is a saving of 
125 per cent. 
Dr. 8. P. Collings, Surgeon to the Indianapolis City Hospital. 
I used the sulphate of cinchonidia in the surgical wards 
of the City Hospital for several months, and gave it, I 
think, a fair trial. Found it equal to quinia in every re- 
spect. 
Dr. John C. Nottingham, Marion, Ind. 
So far as I have used cinchonidia, the action has been 
as prompt and effective as quinia, without any cerebral 
disturbance. I know of no reason why it should not take 
the place of quinia in almost all cases requiring that drug. 
Dr. G. O. Woolen, Secretary Indiana State Medical Society, Indianapolis, 
Indiana. 
I have used the cinchonidia furnished me, mostly in my 
own family, in several forms of malarial trouble, and 
found no perceptible difference between it and sulphate of 
quinia, of which I have used a large amount. 
Dr. Jno. A. Gale, Resident Physician of City Dispensary, Indianapolis, Ind., 
Dec. 1, 1875. 
I have used the sulphate of cinchonidia sent me, and 
must say that I was agreeably surprised at the result. 
Subsequently I have prescribed over one hundred ounces 
in my dispensary practice, and have found it the equal of 
quinia in the treatment of intermittent and remittent 
fevers. It has the material advantage of producing little 
or no cerebral disturbance, which renders quinia so disa- 
greeable. In the case of women and children, I have a 
decided preference for sulphate of cinchonidia over qui- 
nine. As a tonic, the sulphate of cinchonidia is particu- 
larly efficacious, being much superior to the sulphate 
of quinia. 
I have formed the above-expressed opinion of this 
remedy from actual experience in its use. 17 
Dr. J. W. Pritchett, Corresponding Secretary of Kentucky State Medical 
Society, Madisonville, Ky., Dec. 24,1875. 
The sulphate of cinchonidia has been all that you 
claimed for it, and even more. I have not prescribed a 
drachm of quinia since October; have used cinchonidia 
exclusively, and its effect has been most happy. The bad 
effects (cinchonism) that result from the use of quinia are 
not felt when the sulphate of cinchonidia is used. I use 
it in same size dose (by weight), and find it equally as 
reliable and efficacious in the malarial diseases that are so 
prevalent during our autumn months. I have not given 
it a trial in pneumonia, or the diseases incident to our 
winters, but I would not hesitate to prescribe it when 
quinine was indicated. 
Dr. T. 8. Bell, Medical Department University of Louisville, Louisville, Ky., 
Dec. 25,1875. 
I have used the sulphate of cinchonidia as satisfactorily 
as I have used quinidia or quinine. I have not seen it 
fail in any instance. I administer it in the same doses 
that I use in quinidia or quinine. It is equally as effective 
as the quinine, and is not as apt to produce disagreeable 
effects in the head. I have used large quantities of the 
sulphate of cinchonidia, and I do not desire a better rem- 
edy for intermittent and remittent fevers. The results of 
the use of sulphate of cinchonidia in the Kentucky Insti- 
tution for the Blind, under my medical supervision, have 
been satisfactory in the highest degree. I gave four 
ounces of the sulphate of cinchonidia to Dr. Robarts, who 
has charge of the University Dispensary, and he speaks 
of the results there in terms similar to those that I have 
expressed as of my personal knowledge. 
Dr. John E. Pendleton, Hartford, Ky., Dec. 23,1875. • 
I have used sulphate of cinchonidia in a number of 
cases, and the results were very nearly equal to those of 
the sulphate of quinia. The paludal diseases we had here 
at the time I received the sulphate of cinchonidia were 
more than ordinarily intractable, frequently assuming a 
pernicious or congestive type. Not being acquainted 
with the sulphate of cinchonidia, I feared to risk it in the 18 
worst cases, as often a second paroxysm would be fatal; 
but since I have tested it, I should not feel great anxiety 
for a patient who had taken forty grains of your alkaloid 
in the " interval," even in the worst cases. From the 
short acquaintance I have had with the sulphate of cin- 
chonidia, I feel safe in saying that, though possibly not the 
equal of quinine as an antidote to the paludal toxaemia, 
it is next to that agent, of all the remedies of which I have 
any knowledge. 
Dr. John A. Octerlony, of Louisville, Ky., Dec. 31,1875. 
Since the beginning of October, I have made the ther- 
apeutic value of sulphate of cinchonidia an object of 
special study. I have used it in private practice, and in 
my ward at the hospital, and I wish there was time to 
work up the notes taken in both these fields of observa- 
tion ; but just now there is not, and I must be content with 
giving my opinions on this subject, rather than the facts 
upon which they are based. 
The greater cheapness of sulphate of cinchonidia renders 
its use in public institutions a matter of duty, if it can be 
shown that this salt is as much to be relied upon as sul- 
phate of quinia. 
I gave it in about forty-five cases of malarial fever, this 
autumn, and in all but two it proved as efficient and 
thorough a remedy as the corresponding quinia salt. 
The dose required in these cases did not exceed that of 
sulphate of quinia. 
The sulphate of cinchonidia was invariably found to 
produce very little or none of the disagreeable symptoms 
collectively termed cinchonism; and in the malarial dis- 
eases of children I found it superior to quinia, because 
less disagreeable and less liable to cause vomiting. 
I hav.e tested the antipyretic properties of sulphate of 
cinchonidia in six cases, and found them to be nearly if 
not as well marked as when I have given quinia. 
The two cases mentioned above, in which the cheaper 
salt failed to effect a cure, were of very long standing, and 
both arsenic and quinia had to be used before a cure was 
completed. 19 
From J. Murray Rogers, m. d., Memphis, Tenn., Dec. 20th, 1875. 
I have given the cinchonidia a thorough test, as inter- 
mittent fevers were never so universally prevalent through- 
out the entire Mississippi valley as they have been during 
the fall months of this year, and can safely say that it 
has proven as equally efficacious as the sulphate of quinine, 
at the same time being divested of some of the unpleas- 
ant results of the latter affecting the stomach and head, 
and would cheerfully recommend its trial and use to the 
profession. 
From M. S. Croft, Jackson, Miss., Dec. 21st, 1875. 
I have not had opportunity or time to put cinchonidia 
to a test. I have used it but one time; it then checked an 
intermittent when quinine had failed. I gave twenty-four 
grains in four doses. Will try it if cases present, and 
report to you, with pleasure. 
Drs. John and Samuel H. Chester, Jackson Tenn., Dec. 23d, 1875. 
It is with much pleasure that we can state that we have 
given your sulphate of cinchonidia a fair trial, in cases 
where quinine could not be tolerated, such as intermit- 
tent and remittent fevers, etc., and are very much pleased 
with its theraneutic action. We find that it does not pro- 
duce sick stomach, and does not disturb the head, etc., as 
is the case with quinine. We can, therefore, recommend 
it to the profession, and will use it ourselves whenever an 
opportunity presents itself. 
Dir. A. W. Smith, House Surgeon, New Orleans Charity Hospital, Jan. 17,1876. 
I deem it right to state that for some time past many of 
the attending physicians and surgeons to this hospital 
have been prescribing sulphate of cinchonidia in place of 
quinia. Several of the professors of the medical depart- 
ment of the University of Louisiana have used this salt 
to a greater extent than any other. 
Dr. S. M. Bemiss, Professor of Theory and Practice of 
Medicine, requests me to say that thus far it has given 
him the fullest satisfaction, and that its effects seem to be 
the same as that of quinia. 20 
Dr. C. Beard, Professor in the Charity Hospital School 
of Medicine, and Dr. Thebault, also one of our attending 
physicians, say that they are satisfied with the results of 
their trial of sulphate of cinchonidia, and that they pre- 
scribe it in the same dose as quinia, and that malarial 
diseases yield as readily under its use. 
Dr. P. C. Boyer, Attending Physician and Surgeon to 
the Hotel Dieu, says that he has used sulphate of cincho- 
nidia for some time, and that its action on malarial diseases 
is similar to that of quinia. 
I can safely say, from the short experience of the use 
of the sulphate of cinchonidia in this hospital, that it can, 
with confidence, be prescribed instead of quinia, and that 
the difference, if any, required in the dose will not begin 
to compare with the difference in the cost of the two 
preparations. 
From W. W. Hall, M. D., Grenada, Miss., Dec. 27, 1875. 
I have used the sulphate of cinchonidia more or less 
for more than a year, with satisfactory results. During 
the past summer and fall our supply of quinine was ex- 
hausted, and I was driven to the necessity of prescribing 
the cinchonidia in the worst class of cases. While I con- 
fess to a partiality for quinine in cases of congestion, I 
must say that the cinchonidia in no case failed. Com- 
bined with one-third quinine, it has been equally as prompt 
as quinine alone. 
From E. W. Hughes, Grenada, Miss., Dec. 25,1875. 
I have prescribed the sulphate of cinchonidia in inter- 
mittent and remittent fever, with the best results. 
From J. M. Gray, m. d., Holly Springs, Miss., Dec. 20, 1875. 
I received and have used the specimen of cinchonidia. 
I have been very much pleased with its effects. I have 
requested my druggist to keep it. 
From W. H. Ford, m. d.. Canton, Miss., Jan. 3, 1876. 
I take pleasure in saying that I have used sulphate of 
cinchonidia in a varietv of cases, adults as well as child- 21 
ren, by the mouth and rectum, in about the same doses as 
I usually prescribe quinia, and have not been able to 
observe any difference in the action of the two salts. In 
my hands the preparation has been quite as reliable as the 
quinine, and does not seem to have produced cinchonism 
as readily. 
From D. W. Booth, m. d., City Hospital, Vicksburg, Miss., Dec. 28,1875. 
During the past six weeks I have used, in the crowded 
wards of this Institution, in the treatment of nearly every 
variety of malarial disease, the sulphate of cinchonidia, to 
the entire exclusion of the sulphate of quinia, and am so well 
satisfied with its utility as a substitute that I shall con- 
tinue its use. I have consumed some twelve or fifteen 
ounces in the treatment of over one hundred cases of 
intermittent and remittent fever, and with as satisfactory 
results as I ever had in treatment of the same types of 
disease with the sulphate of quinia. 
I can corroborate what is claimed, in this remedy's not 
producing the unpleasant head symptoms of quinine; by 
no means the least important of its virtues as a remedial 
agent. 
From Charles T. Reber, m. d., Shelbyville, Ill. 
In the Druggists' Circular, for November, appears an 
article originally published in the London Lancet, written 
by Surgeon Major Geo. Yates Hunter, of Bombay, on sul- 
phate of cinchonidia, that must be quite perplexing to 
those who have used that article of medicine with quite 
different results; so much so, in fact, as to raise at least two 
questions. First, whether the drug used by Surgeon 
Major Hunter is the same as that manufactured by 
Powers & Weightman and Rosengarten & Son; or whether 
the malarial fevers of Bombay are different from those of 
this country? For one, I must say that one or the other 
must be true, if Hunter gave the drug a fair and unpre- 
judiced trial. I would modestly suggest that the drug 
did not have a fair trial. He says: " I treated fifty-five 
cases of fever, chiefly intermittent, of a mild form, due 
to sudden changes of weather, exposure to the cold, pri- 22 
vation, etc., or indiscretions in diet." Now, what does 
such a trial amount to ? And the particulars in regard to 
these cases given by him are not worth anything, for no 
intelligent practitioner lays any claims for cinchonidia, nor 
indeed for quinia, in such cases. 
He further states that, in several cases of a severe type, 
cinchonidia completely failed, and quinia had to be re- 
sorted to. "And in one bad case of remittent fever, 
which I regret to say ended fatally, cinchonidia was tried 
for two days, and was discontinued on account of proving 
ineffectual" (and here leaks out a secret), " thus strengthen- 
ing my impression'' etc. What impression? How was 
this impression produced? Surely not from his own ex- 
perience, if he states that experience correctly and fully, 
and he certainly has no desire to say anything in favor of 
cinchonidia. 
I have prescribed cinchonidia in place of quinia for 
eighteen months, have used over one hundred and twenty- 
five ounces, have never prescribed over forty grains per day, 
have used it in intermittent, remittent, typho-malarial and 
congestive cases, have used it in over fifteen hundred cases, 
and am as well satisfied with its therapeutic effects as with 
those of quinia; have never had to resort to quinia or any 
other agent to arrest any case that could be arrested by a 
cinchona alkaloid. 
Dr. Hunter states it produces headache almost amounting 
to semi-congestion of the brain. Now, what pathological con- 
dition is that? It is certainly very finely put. It produces 
far less cerebral disturbance than quinia. 
As to its locking up the secretions, I will simply say it 
does just the reverse in this part of the United States of 
America, whatever it may do when combined with opiates 
at Bombay. 
I can write nothing more in answer to, or in criticism 
of, Surgeon Major Hunter's article; and but for the fact 
that it is desirable the profession should know the truth 
in regard to its materia medica and therapeutics, I should 
not have written one word on the subject now. I have 
no axe to grind, no hobby to ride, do not condemn quinia. 
I would be glad to have every one who wishes a good 23 
substitute for quinia try cinchonidia fairly, with a view to 
testing its merits alone. 
It seems to me Dr. Hunter must have sulphate of cin- 
chonia on trial. His article fits my experience with that 
agent exactly, excepting the headache almost amounting to 
semi-congestion. 
From C. H. Fort, m. d., Adams Station, Robertson County, Tenn., Jan. 27th, 
1876. 
I pronounce the cinchonidia equal to any of the prepa- 
rations of barks, and as reliable in the treatment of all our 
malarial types of fevers. I believe I have given it a fair 
test in all our diseases, and I am so far entirely satisfied 
with it. I have used but little except cinchonidia in the 
past twelve months. I commenced using it in the spring 
of 1874. I have as yet had no complaints, even from very 
nervous and hysterical females, of the unpleasant effects 
of sulph. quinine, and it has been quite a source of amuse- 
ment to me how they are disappointed when I give them 
the cinchonidia, they thinking it is quinine, and express- 
ing themselves as being rejoiced that they have changed; 
since they suffer from no unpleasant symptoms. The effect 
of the cinchonidia lasting longer than sulph. quinine, makes 
it a little better antiperiodic, and consequently I prefer it 
in all cases of chronic fever and ague. I have relieved 
many cases that bid defiance to quinine and arsenic. I 
have tested all the preparations of barks upon myself (be- 
ing a fit subject for malaria), and have watched their 
effects closely, both by the thermometer and my feelings; 
and being also more easily administered it is more prefer- 
able for children. 
From Dr. John S. Dare, Bloomingdale, Ind., Jan.31st, 1876. 
I confess to a slight determination not to believe the 
cinchonidia better than quinine. To the use of the sul- 
phate cinchonidia my prejudices have yielded, and now 
the only difference in the two seems to be in price, the 
cinchonidia being the cheaper remedy. I am now satis- 
fied, and hope the continued use of the cinchonidia will 
enable me to discard the aid of its cousin, quinine, from 24 
my practice, though its many favors during the past thirty- 
four years shall not go unremembered. 
I 
Want of space forbids our inserting extracts from a 
number of letters from physicians affording testimony 
similar to the above. 
It is proper to add that the profession have very 
promptly given attention to a candid examination of the 
new remedy, even in cases where there was a very natural 
disposition to rest upon quinia alone. We take occasion 
to say that their kind attention has been truly gratifying. 
POWERS & WEIGHTMAK