Case 7.—This case was one of mixed infection (benign tertian and estivo-autumnal). The patient had a clinical history of malaria dating back two weeks, with a maximum temperature of 104 on admission. Tertian rings, estivo-autumnal rings and crescents were found in the blood. The patient was placed in bed, given thorough eliminating treatment, and 1⁄2 ounce of Sinkina was administered four times daily. His clinical symptoms ran on for two days with no change, and there was no difficulty in finding the plasmodia in blood-smears, which were taken twice daily. The dose was then doubled and at the end of four days more there was no change in either his clinical symptoms or the blood-findings. The patient was then placed on 10 grains of quinin sulphate with 15 drops of diluted hydrochloric acid three times daily, to which he responded in less than forty-eight hours and made an uneventful recovery.
Case 8.—This was the other case of benign tertian malaria. The patient had chills every other day while on the treatment, and laboratory diagnosis confirmed the clinical findings. Experimental treatment was carried on for four days, with a negative result.
The investigator calls attention to the fact that the first case in which improvement resulted does not show any necessary connection with the Sinkina administered, for many cases of benign tertian malaria will clear up in just as short a time under any line of treatment, while practically all will eventually do so. This investigator later reported another case and transmitted a clinical chart.
Case 9.—This patient was admitted to the hospital, Dec. 30, 1912, with a history of having had malaria for some weeks. The diagnosis was confirmed by a blood examination. He was then carried for four days without treatment other than rest in bed and a liquid diet. His symptoms subsided by the third day. On the fourth day a count of the parasites was made which showed that there were 1,160 asexual parasites and 260 sexual forms to every thousand leukocytes. The following day he was placed on Sinkina, 1 ounce three times daily. There was exacerbation of symptoms on the following day, which gradually increased until the fourth day, remaining about stationary for a day or so. The fifth day after the patient had been placed on Sinkina, another count of the parasites showed 5,600 asexual parasites and 300 sexual forms to the thousand leukocytes, this being an increase of 4,440 asexual forms and forty sexual forms to every thousand leukocytes. With the second count of parasites the dose of Sinkina was increased to 2 ounces every four hours, the patient being kept on this until January 14, without result. He was then placed on quinin, with a complete reduction of the temperature to normal and the disappearance of the parasites from the blood.
The investigator also reported a case of benign tertian malaria.
Case 10.—This was in a child of 8 years which was treated by the investigator’s confrère and gave similar negative results. Blood examination showed numerous parasites. The child was placed on 1 ounce of Sinkina three times a day and kept on it for two weeks. The clinical picture remained unaltered, and parasites could be detected in numbers whenever examinations were conducted. A gradually increasing enlargement of the spleen was also noted. At the end of two weeks quinin was substituted, and the child went on to a rapid and uneventful recovery.
This investigator also concludes that the claim put forth by the Metropolitan Pharmacal Company that Sinkina is a specific in the treatment of the malarial fevers is entirely without foundation, and that the firm will be unable to demonstrate to the contrary.
These investigations demonstrate that Sinkina is not a specific against malaria, and that it has no more effect than a mixture of oil of cumin, sugar, alcohol and water. They further show the fallacy, first, of concluding from a temporary cessation of the symptoms in malaria that the disease has been cured and, second, of ascribing such temporary improvement to the influence of a remedy which has no known effect on the malarial organism.—(From the Journal A. M. A., Sept. 27, 1913.)