abc@brl-smoke.ARPA (Brint Cooper ) (10/27/86)
I have just learned, from a 1983 publication, that sufferers
from myasthenia gravis (MG) should avoid the medical use of quinine and
other anti-arrythmics (sp?). The article didn't mention if the drinking
of tonic water was also to be avoided.
We spent July in Switzerland and Italy, where you buy your
drinking water. It is almost always a "mineral water," and the
ingredients are tabulated on some labels. This was my sole source of
drinking water for a month and I drank several litres each day.
Does anyone know what the chances are that quinine was present
in any of the commercial mineral waters sold in Europe? I am quite
naive in this area; I haven't the foggiest notion of what quinine is.
All I know is that, not long after returning from our trip, I suffered
an attack of the MG that still hasn't relented in spite of taking lots
more medicine and doing almost nothing physical.
--
Brint Cooper
ARPA: abc@brl.arpa
UUCP: ...{seismo,unc,decvax,cbosgd}!brl-smoke!abcdyer@spdcc.UUCP (Steve Dyer) (10/27/86)
In article <4919@brl-smoke.ARPA>, abc@brl-smoke.ARPA (Brint Cooper ) writes: > I have just learned, from a 1983 publication, that sufferers > from myasthenia gravis (MG) should avoid the medical use of quinine and > other anti-arrythmics (sp?). The article didn't mention if the drinking > of tonic water was also to be avoided. > We spent July in Switzerland and Italy, where you buy your > drinking water. It is almost always a "mineral water," and the > ingredients are tabulated on some labels. This was my sole source of > drinking water for a month and I drank several litres each day. > Does anyone know what the chances are that quinine was present > in any of the commercial mineral waters sold in Europe? I am quite > naive in this area; I haven't the foggiest notion of what quinine is. > All I know is that, not long after returning from our trip, I suffered > an attack of the MG that still hasn't relented in spite of taking lots > more medicine and doing almost nothing physical. Among its varied effects on all sorts of physiological systems, quinine decreases the sensitivity of the neuromuscular junction to acetylcholine, thus exacerbating a disease like myasthenia gravis which exerts its symptoms through a reduction in the sensitivity of the neuromuscular junction to ACh. A therapeutic dose of quinine, such as would be administered for leg cramps or (rarely) for malaria, can produce an alarming intensification of symptoms in MG patients, such as respiratory distress and difficulty in swallowing. However, these are acute effects of the drug stemming directly from its pharmacological actions on skeletal muscle; whether there are lasting sequelae in an MG patient, I don't know. Quinine is extremely bitter, and small quantities are used in "quinine water" and "tonic water" as a bitter flavoring. I'm not sure exactly how much drug you'd receive from a typical gin and tonic, but I suspect it's very small. If the mineral waters you drank in Europe didn't have the distinctive bitter taste of tonic water (and most of the waters I've had in Europe don't), I suspect that you don't have to worry about quinine being an ingredient. What's more, all the reports I've seen mention quinine's ACUTE effects in MG patients. I think it's less likely that you could be exposed to quinine, suffer no reaction, and then have a flareup due to the exposure weeks later. Like a lot of other auto-immune diseases, MG symptoms maddeningly wax and wane from stress, or for no apparent reason at all. What does your doctor say? -- Steve Dyer dyer@harvard.HARVARD.EDU {linus,wanginst,bbnccv,harvard,ima,ihnp4}!spdcc!dyer
werner@aecom.UUCP (Craig Werner) (10/29/86)
> > I have just learned, from a 1983 publication, that sufferers > from myasthenia gravis (MG) should avoid the medical use of quinine and > other anti-arrythmics (sp?). The article didn't mention if the drinking > of tonic water was also to be avoided. > We spent July in Switzerland and Italy, where you buy your > drinking water. It is almost always a "mineral water," and the Tonic water has to have quinine added to it. Quinine is derived from the Chichona bark and does not occur naturally in mineral springs. If it were added, it would have to be clearly marked 'Contains Quinine' since Quinine can cause massive hemolysis (red blood cell destruction) in people who lack an enzyme called G6PDH (Glucose-6-Phosphate Dehydrogenase), which is prevalent in Southern Europe. It certainly wouldn't be put in the water in Italy. I give research seminars on malaria, and am somewhat of an expert on the subject. It is THE most common debilitating disease in the world, with 100 MILLION cases a year worldwide (Intestinal roundworms, Ascariasis, is more prevalent, but usually assymptomatic. In fact, almost a quarter of the world's population has worms). I could talk for hours about it (and have), but will only mention the efficacy of Gin and Tonics. Yes, the Gin and Tonic does indeed contain enough Quinine to inhibit the replication of the Plasmodium falciparum (malaria) merozoite. The parasite is also exquisitely sensitive to alcohol. Hence, the British custom of drinking Gin and Tonics probably was a life-saver for many a colonialist. -- Craig Werner (MD/PhD '91) !philabs!aecom!werner (1935-14E Eastchester Rd., Bronx NY 10461, 212-931-2517) "Knowing you, you're probably doing twice as much as is healthy for you."
cetron@utah-cs.UUCP (Edward J Cetron) (11/02/86)
In article <539@aecom.UUCP> werner@aecom.UUCP (Craig Werner) writes: > Yes, the Gin and Tonic does indeed contain enough Quinine to >inhibit the replication of the Plasmodium falciparum (malaria) >merozoite. The parasite is also exquisitely sensitive to alcohol. >Hence, the British custom of drinking Gin and Tonics probably was a >life-saver for many a colonialist. > >-- > Craig Werner (MD/PhD '91) for once I disagree with Craig (and oh what a minor point) I think the gin and tonic BECAME a custom do to the lousy taste of quinine by itself as opposed to the other way around....:-) -ed cetron Center for Biomedical Design
chrisp@phred.UUCP (Chris "Slugger" Pearce) (11/11/86)
I can't shed much light as to how much (if any) quinine is in mineral water, but it certainly is in "bitter lemon", a very popular carbonated beverage sold in Europe. The proportion of quinine is less than 0.1%, if I remember correctly. Cadbury schweppes is the manufacturer.
MJWCU@CUNYVM.BITNET (11/18/86)
All this discussion of the quinine in 'Tonic water' has me sort of worried now. I recently gave up a long term affair with beer, and have selected tonic water, with a twist of lime, as it's substitute. (I know, what a shitty substitute for beer!) Anyway, my question is, are there any harmful affects associated with consuming large quantities of tonic water, (Two or more liters a day)? (Tonic may be a shitty substitute for beer, but over the course of about four months, I've lost 25 pounds of beer-belly!) - Marty Walsh -
artm@phred.UUCP (11/20/86)
In article <169MJWCU@CUNYVM> MJWCU@CUNYVM.BITNET writes: > >my question is, are there any harmful affects associated with >consuming large quantities of tonic water, (Two or more liters >a day)? > I seem to recall that a couple of years ago there was something published about quinine having an adverse effect on night vision. It may have been a beaurocratic overreaction, but I believe it caused the Air Force to prohibit pilots from drinking anything with quinine within something like 48 hours of flying. Then again, maybe it had something to do with the quantity of gin or vodka added ;-) Opinions? Opinions? I only deal in pure fantasies.... Art Marriott Physio-Control tikal!phred!artm ........................................................................... One hand for the coffee cup, the other for the N key... .................................................................................