Cinchona,—Peruvian Bark.

Related entry: Cinchona Alkaloids

Official Species of Cinchona are two, viz.:—

(1). Cinchona,—the bark of Cinchona Calisaya, C. officinalis, and of hybrids of these and other species of Cinchona, (nat. ord. Rubiaceae), yielding not less than 5 p. c. of total alkaloids, and at least 2 ½ p. c. of Quinine.

(2). Cinchona Rubra, Red Cinchona,—the bark of Cinchona Succirubra, containing not less than 5 per cent. of its peculiar alkaloids.

Cinchona Flava, Yellow Cinchona,—is the bark of C. Calisaya.

Cinchona Pallida, Pale Cinchona,—is no longer official.

Peculiarities possessed by each variety. They should contain not less than 5 p. c. of the alkaloids and at least 2 ½ p. c. of Quinine. Yellow Bark contains most Quinine, Pale Bark most Cinchonine, while the Red Bark has these alkaloids in about equal proportions. The tree is a native of the western mountains of S. America, and has been planted largely in India, Ceylon and Burmah. The Bark from Colombia affords no alkaloids except Quinine.

Composition of Cinchona. It contains 4 chief alkaloids and 17 others, also 2 simple acids, 2 tannic acids, a resinoid, and coloring matter, as follows

Chinoidin, Quinetum, and Quinquinina. Chinoidin is the black, bitter residue left after the crystallizable alkaloids have been removed from the mother-liquor, and it evaporated. It contains the four alkaloids in amorphous condition, and has about one-fourth the strength of Quinine. Quinetum (also called Quinquinina) is an impure preparation, much used in India. It contains all the alkaloids, the woody fibre being removed, and is about half as strong as Quinine.

Preparations.

Infusum Cinchonae,—Dose, ʒj-℥ij. Cinchona 6, Aromatic Sulphuric Acid 1, Water to 100. Is the only official infusion containing Sulphuric Acid.

Tinctura Cinchonae,—strength 20 per cent. Dose, ʒss-ij.

Tinctura Cinchonae Composita,—a substitute for Huxham's Tincture of Bark, strength 10 per cent., ʒj-℥ss. Contains Cinchona Rubra 10, Serpentaria 2, Orange Peel 8, Glycerin 7 ½ , Alcohol, Water, aa q. s. ad. 100.

Quinine Sulphas,—Quinine Suphate. Dose, gr. j-xx, even xl. Soluble in 740 parts of cold water, and in smaller proportions of acidulated water.

Cinchonidinae Sulphas, Cinchonidine Sulphate—Dose, gr. ij-xxx. It is being much used, especially in hospitals and dispensary work.

Incompatibles. Free Tannic Acid is incompatible with the infusion. Iodine, Alkalies, Alkaline Carbonates and earths are incompatible with the alkaloids, the first named forming insoluble compounds therewith, and the latter precipitating them from solution.

Antagonists. As to its cerebral action Morphine is antagonistic; Belladonna or Atropine to its nervous, cardiac, and antipyretic powers.

Physiological Action. Cinchona is an astringent bitter tonic, an antiseptic, antiperiodic, antiphlogistic, antipyretic and antimiasmatic, a diminisher of reflex action, a protoplasmic poison, and a direct emmenagogue and an oxytocic. Its alkaloids are rapidly diffused and slowly excreted, being found in the urine in ¼ of an hour after administration, and for three days afterwards. At first it promotes appetite, digestion, the flow of saliva and of gastric juice; but long continued it sets up a gastric catarrh, impedes digestion and causes constipation. It arrests the movements of the white blood corpuscles, though increasing their number; and prevents acetification and decay of the blood. The Heart and arterial tension are somewhat stimulated by small doses, but depressed by large ones (gr. xl-lxx), which slow and enfeeble the pulse, the drug acting directly on the cardiac ganglia. The Brain is exhilarated by small doses, large ones causing anaemia, pallor, a sense of fullness and constriction in the head, singing in the ears, vertigo, a staggering gait, amaurosis and deafness (though the eyes and ears are rarely ever injured seriously), great headache, coma, dilated pupils, delirium, and in animals convulsions. These symptoms collectively are termed Cinchonism. The Reflex Function of the cord is lowered very markedly by large doses. The Spleen is reduced in size, and the temperature of pyrexia lowered, though it does not depress the body temperature in health. In some subjects it causes sexual excitement, in others cutaneous eruptions followed by desquamation; it lessens the excretion of uric acid, but not that of urea; and is a uterine stimulant in labor. Its power to initiate uterine contractions is still a much debated question.

Therapeutics. The principal use of Cinchona is in the malarial diseases, over which its influence is that of a specific. In—

Intermittents,—gr. x of Quinine Sulphate in the sweating stage and again five hours before the expected time of the next paroxysm. Arsenic in the intervals, in lieu of Quinine, which may cause a daily exacerbation of temperature if long continued.

Remittent Fever,—gr. xx-xxx of Quinine Sulphate once or twice a day, until the temperature is reduced to the normal point.

Pernicious Fevers,—large doses of Quinine gr. xxx-lx, are necessary to safety.

Chronic Malarial Poisoning,—Chinoidin is more effective than Quinine.

Prophylactic, against malaria—Quinine, gr. ij-iij per diem, is effective.

Inflammations,—at their inception, may be aborted by Quinine, gr. xv-xx, combined with Morphine, which here is synergistic to it.

Acute Tonsillitis,—may sometimes be aborted by Quinine in full dose.

Acute Catarrh,—may often be aborted by Quinine, gr. x, Morphine, gr. ¼.

Surgical Fever—and before surgical operations, Quinine is much used.

Septicaemic Fevers, and Hectic, are well treated with Quinine and Alcohol.

Neuralgias,—of the ophthalmic div. of the 5th, and when due to malaria.

Skin Diseases,—especially erythema nodosum, and erysipelas.

Eruptive Fevers,—especially scarlet and measles, throughout course.

Hay asthma,—a solution of the neutral chloride, gr. vj ad ℥j locally.

As a Tonic,—the Infusion or Compound Tincture is best with a mineral acid; has many applications, as in atonic dyspepsia, gastric catarrh of drunkards, adynamic states, convalescence, asthma, chronic bronchitis, insanity, and generally in weak subjects of flabby flesh and perspiring skin.

A Compend of Materia Medica, Therapeutics, and Prescription Writing, 1902, by Sam'l O. L. Potter, M.D., M.R.C.P.L.