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December 9, 1911

The Relation of Tetanus to the Hypodermic or Intramuscular Injection of Quinin.

JAMA. 1911;LVII(24):1937. doi:10.1001/jama.1911.04260120127028

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In tropical countries and wherever the existence of pernicious forms of malarial infection require prompt saturation of the blood with quinin by means of hypodermatic injections, there are occasionally observed tetanus infections following these injections. As injections of morphin, atropin, and other drugs which are given hypodermatically much more frequently than quinin are not followed by tetanus, the evidence seems plainly to incriminate the quinin. This book is a monograph discussing the subject and reporting several series of experiments performed for the purpose of explaining the danger of tetanus from quinin injections. The evidence obtained by the author indicates that the quinin itself, and usually the fluids and instruments used in making the injections, are not infected, but rather the quinin acts indirectly by producing local necrosis and inhibiting phagocytosis. If an animal has been inoculated with washed tetanus spores, which of themselves cannot produce tetanus, an injection of quinin

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