Investigação científica e uso clínico da quina em Portugal na transição do século XVIII para o século XIX / Scientific research and clinical use of quinine in Portugal in the transition from the 18th to the 19th century

A quina, uma casca de árvores nativas da América do Sul do género Cinchona com propriedades antimaláricas, tem um importante lugar na história da medicina e da farmácia. Possivelmente já conhecida pelos espanhóis no século XVI, foi usada na terapêutica pela sua atividade febrífuga, estabelecendo-se como tratamento para as febres intermitentes nos séculos XVIII e XIX. Este artigo pretende avaliar a receção da quina em Portugal no último quartel do século XVIII e no primeiro quartel do século XIX através do estudo de obras portuguesas que descrevem pormenorizadamente as aplicações terapêuticas da quina, do estudo de uma publicação periódica médica, o Jornal de Coimbra e do estudo de receituário médico. Em Portugal, a quina foi também utilizada pela sua ação febrífuga, tendo sido publicadas várias obras descritivas da sua atividade terapêutica quer nas febres intermitentes, quer em doenças como a gota ou na gangrena. No periódico científico português Jornal de Coimbra (1812-1820) foram publicados, por indicação governamental, relatos de médicos de todo o país sobre as doenças existentes nas localidades em que exerciam e respetivo tratamento utilizado. Através da leitura desta publicação, verifica-se que a quina era um tratamento generalizado e normalmente eficaz para as febres intermitentes. No tratamento das febres intermitentes, a quina era geralmente associada a outros medicamentos como os eméticos. A quina foi também a droga mais prescrita num estudo de caso compreendendo 1954 receitas médicas. Foi prescrita por 434 vezes, entre 1779 e 1825, em receitas preparadas pelo Dispensatório Farmacêutico do Hospital da Universidade de Coimbra. Os relatos publicados no Jornal de Coimbra sobre a aplicação clínica da quina, e a percentagem elevada de receitas em que esta foi prescrita comprovam a sua importância na terapêutica em Portugal. (AU)

Quinine, a tree bark native to South America of the genus Cinchona, has antimalarial properties and occupies an important place in the history of medicine and pharmacy. Possibly already known to the Spanish in the 16th century, it was used in therapeutics for its febrifugal activity, becoming established as a treatment for intermittent fevers in the 18th and 19th centuries. This article aims to evaluate the reception of quinine in Portugal in the last quarter of the 18th century and the first quarter of the 19th century by studying Portuguese works that describe the therapeutic applications of quinine in detail, by studying a medical publication, the Jornal de Coimbra, and by examining medical prescriptions. In Portugal, quinine was also used for its febrifugal action, and several works were published describing its therapeutic activity in both intermittent fevers and diseases such as gout and gangrene. Acting on governmental instructions, the Portuguese scientific periodical Jornal de Coimbra (1812-1820) published reports by doctors throughout the country on diseases observed in the places where they practiced and on the treatments they applied. Reading this publication shows that quinine was a widespread and usually effective treatment for intermittent fevers, commonly combined with other drugs such as emetics. Quinine was also the most prescribed drug in a case study comprising 1,954 prescriptions. It was prescribed 434 times between 1779 and 1825 in prescriptions prepared by the Pharmaceutical Dispensatory of the Coimbra University Hospital. The reports in the Jornal de Coimbra on the clinical application of quinine and the high frequency of its prescription demonstrates its important therapeutic role in Portugal. (AU)

Quinine in Otology and Neurotology: Ototoxicity and Historic Role in Therapy.

OBJECTIVES/HYPOTHESIS: Quinine, a cinchona bark-derived antimalarial alkaloid, is a known ototoxic. Isolated and named in 1820 by the French scientists Pierre-Joseph Pelletier and Joseph-Bienaimé Caventou, it has since been employed in the treatment of different maladies. Quinine was also recommended as a local anesthetic in surgical procedures in the early 20th century. This article aims to identify early ototoxicity reports regarding quinine and to investigate if quinine was previously used in otology as an anesthetic agent or as an actual therapy. METHOD: Historical review of medical and pharmaceutical literature from the 19th and 20th centuries in databases (PubMed; Web of Science), as well as medical books on ototoxic drugs, quinine, and therapies in otology. RESULTS: The first identified reference of quinine ototoxicity was from 1824. Quinine also had a therapeutic role in otology and neurotology and was employed for its analgesic properties. It was used in Menière's disease, vertigo, otalgia, purulent otitis media, neuralgia of the plexus tympani, furuncles in the auditory canal, and herpes zoster in the auricle. CONCLUSION: Quinine was acknowledged as an ototoxic drug in the 19th century. Quinine was used in several otologic disorders, both as an analgesic (for herpes zoster, otalgia) and as a therapeutic agent (Menière's disease, vertigo, purulent otitis media, furuncles in the auditory canal). This research demonstrates that, analogously to gentamicin, quinine was used in Menière's disease specifically due to its ototoxic effects.