Notes on Intravenous versus Intramuscular Quinine

as far as my memory goes, quinine by the intramuscular route was not only regarded as bad Practice, but was absolutely taboo, at least in the division in which I served. I can still remember the trepidation with which I administered quinine intramuscularly in 1917; I hoped that the brand of Cain, which I was certain must have glowed on my forehead, was not too visible to those who saw these performances. I lived in fear of tetanus and abscess for days after each such case; my fear was never justified. I have never abandoned the intravenous route, but I have used the intramuscular with everincreasing confidence, a confidence which I have never found misplaced. Most of my experience of quinine by injection came subsequently to 1920 when I took up tea-garden practice. My reasons for its adoption were several: firstly, there is less actual Preparation in giving the injection and this appeals to the coolie. The puncture is made rapidly and the injection is all over in a minute or two. With intravenous quinine, more time is expended. It is often necessary in tea-garden practice to have an assistant to hold the arm and the time of injection is much longer depending on the dilution of the solution used which should never be less than 10 c.cms. The coolie enjoys the quicker route, and the absence of fuss and assistants makes for confidence. This is a very essential point in dealing with ignorant labourers. Site.?I usually prefer the buttock in children as it is easiest to inject. In working adults also, f generally prefer the buttock, because, if there is any residual tenderness, the patient is not rendered unfit for his manual occupation.