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Wonder drug quinine was widely used to combat malaria. By Ted Maguder
Part of an occasional series
THE WONDER DRUG during the Civil War was quinine. The use of quinine was well known and understood by Confederate and Union physicians, and it was a valuable drug in the supply table of both armies.
The Medical Department of the Union Army purchased 595,544 5-ounce tins of quinine sulphate during the war. It was used during the 19th century to cure malaria, and it still is, despite synthetic drugs that became available in the early 1940s.
Quinine is found in the bark of the cinchona tree of South America. It was prepared as early as the 17th century. The drug acts upon the effects and reproduction of the malarial parasites, or sporozoa, injected by anopheles mosquitoes as they take a blood meal.
The malarial parasite was not identified until 1880, and mosquito transmission not demonstrated until 1898. But every Civil War physician knew how to treat the symptoms of ague, or intermittent fever. One Georgia regiment of 878 soldiers reported 3,313 cases in a little over a year.
The symptoms are chills, shakes, fever and headache occurring every four to six hours. It was recognized that soldiers camping at night near swampy, wet areas often came down with these symptoms. Physicians blamed the swampy night air. Mal aria equals "bad air."
But sometimes lessons learned are not well remembered. During World War II, malaria was the No. 1 disease of troops in the South Pacific, the Mediterranean and Burma, sometimes causing more than five times as many casualties as combat. During the Civil War, it was thought that one out of every four cases of disease was malaria.
Treatment included whiskey along with the quinine, calomel and opium or laudanum. Occasionally, blistering was performed. It was thought that the disease could be brought to the surface of the body and expelled by applying irritants to the skin. Turpentine, ammonia, a crushed beetle called "Spanish fly," and even boiling water were utilized to cause blisters. The blisters would be lanced to try to rid the body of the disease.
We now know that quinine works primarily by reducing body temperature--up to 107 degrees Fahrenheit during the feverish periods--and thereby preventing organ failure.