The diseases of infancy and childhood : for the use of students and practitioners of medicine / by L. Emmett Holt and John Howland.

  • Luther Emmett Holt
Date:
1922
Catalogue details

Licence: Public Domain Mark

Credit: The diseases of infancy and childhood : for the use of students and practitioners of medicine / by L. Emmett Holt and John Howland. Source: Wellcome Collection.

    1138/1172 page 1100
    of the hypodermic injections should be avoided; in most cases, two or three good doses are sufficient, the effect being continued by quinin given by other methods. For children from two to seven years old the taste of quinin must be concealed. An aqueous solution of the bisulphate may be mixed with the syrup of sarsaparilla, orange, or yerba, santa; or the sulphate may be given in suspension in one of the same vehicles, the mixture being made just before the dose is taken; otherwise the partial solution of the drug will render the whole dose exceedingly bitter. When the dose required is not large, as in the milder cases, the lozenges of the tannate of quinin combined with chocolate answer the purpose admirably, for these are so nearly tasteless that children will take them without difficulty. Each lozenge usually contains one grain of the tannate, which is equivalent to about one-third of a grain of the sulphate of quinin. A similar lozenge containing one grain of the sulphate may be made, which is often taken by children without the slightest objection. For children over seven years old, the same methods of administra¬ tion may usually be employed as in adults. It is always preferable to give quinin in solution, or if not so, in capsule, but not in pill form. In a case with well-marked paroxysms the quinin should if possible be given in the interval, with the largest dose about four hours before the expected paroxysm. With infants this plan is sometimes imprac¬ ticable; as frequent small doses are usually better borne by the stomach than a few large ones. In them also vomiting seems less likely to occur when quinin is given on an empty stomach. For this reason it is advan¬ tageous to give the drug at regular two- to three-hour intervals during the night, and omit all medication during the day. Dosage.—Relatively much larger doses of quinin are required for young children than for adults. Except for its tendency to disturb the stomach, quinin is borne remarkably well by little patients. Generally too small doses are given. An infant of a year with a sharp attack of malarial fever will usually require from eight to twelve grains of the sulphate (ten to fourteen grains of the bisulphate) daily. Occasionally we have found it necessary to give double the quantity referred to. It is useless to expect to control an acute attack of malaria by such doses as one grain three or four times a day. Children from five to ten years old require almost as large doses as do adults. None of the substitutes for quinin are to be relied upon in acute cases. In chronic cases tonics such as arsenic and iron are usually required in addition to quinin. In most chronic cases a cure can be effected only by a change of climate. The masked and irregular manifestations of malaria are to be treated in the same manner as cases of malarial fever.
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