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To the Editor:—
In the past several years there has been a steady increase in the use of beverages containing quinine, known variously as tonic or quinine water. Part of this increase in consumption results from advertising and part from the fact that during warm weather this type of beverage has certain advantages over the sweet carbonated type. Since patients with moderate to severe forms of myasthenia gravis are very sensitive to the curare properties of quinine salts, I wonder if it would be a particular hazard for these patients to drink this beverage in warm weather. I recently heard that in Sweden an 11-year-old girl with severe myasthenia gravis had a temporary exacerbation of her symptoms after the ingestion of a bottle of quinine water.With this report in mind the staff of the A. M. A. Council on Foods and Nutrition was consulted. The five leading distributors of
Schwab RS. QUININE WATER AND MYASTHENIA GRAVIS. JAMA. 1960;173(8):932. doi:https://doi.org/10.1001/jama.1960.03020260072021
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