=Treatment.=--The treatment of malaria practically means the use of
quinine given in the proper way and in the proper form and dose.
Despite popular prejudices against it, quinine is capable of little
harm, unless used in large doses for months, and no other remedy has
yet succeeded in rivaling it in any way. Quinine is frequently useless
from adulteration; this may be avoided by getting it of a reliable
drug house and paying a fair price for the best to be had. Neither
pills nor tablets of quinine are suitable, as they sometimes pass
through the bowels undissolved. The drug should be taken dissolved in
water, or, more pleasantly, in starch wafers or gelatin capsules. When
the drug is vomited it may be given (in double the dose) dissolved in
half a pint of water, as an injection into the bowels, three times
daily. Infants of a few months may be treated by rubbing an ointment
(containing thirty grains of quinine sulphate mixed with an ounce and
a half of lard) well into the skin of the armpits and groins, night
and morning. Children under the age of two can be best treated by
quinine made into suppositories--little conical bodies of cocoa butter
containing two grains each--one being introduced into the bowel, night
and morning.
During an attack of malaria the discomfort of the chill and fever may
be relieved to considerable extent by thirty grains of sodium bromide
(adult dose) in water. Hot drinks and hot-water bottles with warm
covering may be used during the chill, while cold sponging of the
whole naked body will afford comfort during the hot stage. In the
pernicious form, attended with unconsciousness, sponging with very
cold water, or the use of the cold bath with vigorous friction of the
whole body and cold to the head are valuable. The effect of quinine is
greatest during the time of birth of a new generation of young
parasites in the blood, which corresponds with the time of the
malarial attack. But in order that the quinine shall have time to
permeate the blood, it must be given two to four hours before the
expected chill, and then will probably prevent the next attack but
one. A dose of ten grains of quinine sulphate taken three times daily
for the first three days of treatment; then a dose of three grains,
three times daily for two weeks; and finally two grains, three times
daily for the rest of the month of treatment will, in many cases,
complete a cure. If the quinine cause much ringing in the ears and
deafness, it will be found that sodium bromide taken with the quinine
(in twice the dose) dissolved in water, will correct this trouble. If
the patient is constipated and the bowel discharges are light colored,
a few one-quarter grain doses of calomel may be taken every two hours,
and followed in twelve hours by a dose of Epsom salts, on the first
day of treatment, with quinine. It is no use to take quinine by the
mouth later than two hours before an attack, and if the patient cannot
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