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September 7, 1940


JAMA. 1940;115(10):876. doi:10.1001/jama.1940.02810360064027

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To the Editor:—  I wish to call your attention to the dangerously misleading impression that might be read into Dr. R. C. Moehlig's report of a case of myasthenia gravis in The Journal, July 13. From the way in which the therapeutic trial of quinine is referred to in this report, one might easily deduce that the drug has been elsewhere reportedly used successfully in the treatment of this disease, especially since it was here administered together with aminoacetic acid. Actually, quinine is definitely contraindicated, as was reported by Kennedy and Wolf (Arch. Neurol. & Psychiat.37:68 [Jan.] 1937). Later, Harvey showed that quinine has a curare-like action, as he reported in The Journal, April 22, 1939, page 1562, and thus its administration enhances the curare-like paralysis of myasthenia gravis. I have seen 10 grains (0.65 Gm.) of quinine produce an alarming state in a moderately severe case

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