Cinchona.
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I. Cinchona.—The dried bark of Cinchona Ledgeriana, Moens; Cinchona Calisaya, Weddell, and hybrids of these with other species of Cinchona yielding not less than 5 per cent of cinchona alkaloids. (Nat. Ord. Rubiaceae.) South American Andes, wild and to some extent cultivated in South America; cultivated in Java, India, Jamaica, and other countries. Dose, 1 to 30 grains.
II. Cinchona Rubra.—The dried bark of Cinchona succirubra, Pavon, or of its hybrids yielding not less than 5 per cent of alkaloids of Red Cinchona (Nat. Ord. Rubiaceae), Ecuador.
Common Names: (1) Yellow Peruvian Bark; (2) Red Cinchona Bark.
Principal Constituents.—Quinine, quinidine, cinchonine, cinchonidine—all important crystalline alkaloids; quinamine, an important alkaloid; kinic (quinic) acid, kinovin (quinovin), cinchotannic acid (astringent); cinchona red (coloring agent); and a volatile oil (aroma).
Preparations.—1. Specific Medicine Cinchona. Dose, 1 to 30 drops. (This preparation is prepared from Cinchona Calisaya or Calisaya Bark.)
2. Fluidextractum Cinchona, Fluidextract of Cinchona. Dose, 5 to 30 drops.
3. Tinctura Cinchona, Tincture of Cinchona. Dose, 10 to 60 drops.
4. Tinctura Cinchonae Composita, Compound Tincture of Cinchona. (Red Cinchona, Bitter Orange Peel, Serpentaria.) A modern substitute for and sometimes wrongly called "Huxham's Tincture of Bark". Dose, 5 to 60 drops.
Specific Indications.—Periodicity and, like quinine, effective when the pulse is soft and open, the tongue moist and cleaning, the skin soft and moist, and the nervous system free from irritation. (If opposite conditions prevail, cinchona will be likely to aggravate.) Empyema; gastric debility; anemia and debility from chronic suppuration; afternoon febrile conditions, weakness, with pale surface, loss of appetite, feeble digestion, and deficient recuperative powers.
Action and Therapy.—External. Antiseptic and astringent. A poultice of the bark has been successfully used upon fetid and gangrenous ulcers, and where such an application has been thought necessary upon suppurating and sloughing felons.
Internal. Cinchona is tonic, antiperiodic, slightly astringent, and mildly antiseptic. In small doses it is a good stomachic, but must not be long continued. Large doses irritate and cause an unpleasant excitement of the stomach and bowels, with retching and vomiting. It has occasioned symptoms closely resembling the paroxysms of intermittent fever, and produces a general state known as Cinchonism: Throbbing headache, tinnitus aurium and temporary deafness. Outside of a slight astringent effect, the action of Cinchona is that of its chief alkaloid, quinine, which has completely supplanted the bark in almost all conditions in which the former was once used. While cinchona will accomplish the same results as quinine, the latter is more prompt and direct and more easily administered.
Cinchona is useful in functional derangements of the stomach, improving digestion, and imparting vigor and tone to the nervous and muscular systems in diseases of general debility and in convalescence from exhausting illness. While for some unexplainable reason occasionally acting more advantageously in malarial fevers than quinine itself, in most instances the alkaloidal salts have almost entirely supplanted cinchona in these disorders. Cinchona may be used in preference to its alkaloids when a tonic effect only is required and periodicity is lacking, or after hemorrhages or exhaustive discharges, as in empyema, or when an astringent tonic is needed; in the debility following low and exhausting fevers; in anemia and debility from chronic suppuration; and to arrest profuse and debilitating night sweats in one suffering from general debility with poor recuperative powers.
