Quinine and Urea Hydrochloride

WLMD ID: apom
Local anesthetics are medications that are injected to numb specific areas of the body. The combination of quinine hydrochloride and urea hydrochloride was introduced in France in 1881. It was first suggested for local anesthesia in 1907 by the American physician, Henry Thibault, M.D. (1877-1931). Injection of the agent into the surface tissues of the body is painful and causes minor tissue destruction. The agent is also noted for having an unusually long-lasting effect, from several hours to several days in duration. The characteristics of prolonged numbing and pain on injection made it more appropriate for abdominal surgery, in deeper, less sensitive tissues. 

In 1915, George Washington Crile, M.D. (1864-1943), a leading American surgeon, strongly seconded Thibault's recommendation. This sparked rising interest over the following decades. The leading French surgeon, Victor Pauchet, M.D. (1869-1936) was one of several authors who credited their use of the agent to Crile's work. Pauchet's student, Louis Gaston Labat, M.D. (1876-1934), wrote the first American textbook on regional anesthesia in 1922. That same year he founded the American Society for Regional Anesthesia. The box shown here was made by Parke, Davis & Co., probably in the 1920s. Quinine and urea hydrochloride continues in use today for the treatment of some painful conditions.

Catalog Record: Quinine and Urea Hydrochloride Quinine & Urea Hydrochloride

Access Key: apom

Accession No.: 2002-09-28-1

Title: Quinine and urea hydrochloride / Parke, Davis & Company.

Corporate Author: Parke, Davis & Company.

Publisher: Detroit : Parke, Davis & Co., [not before 1907 and not later than 1930].

Physical Description: 1 box : pasteboard, paper; 9 x 6.5 x 4.5 cm.

Subject: Anesthesia, Regional.

Subject: Anesthetics, Local.

Subject: Drug Packaging.

Web Link: https://www.woodlibrarymuseum.org/museum/item/1060/quinine-and-urea-hydrochloride
                                     
Note Type: General

Notes: The first year in the date range is based on the date of Thibault’s first description of quinine combined with urea hydrochloride. The second year in the date range is based on the manufacturer’s 1929-1930 Catalog. This catalog features different, more modern packaging for the same product. These differences include sans-serif text, a logo on the top of the box, and individual boxes for each ampoule, instead of divisions within the box. The company’s 1922 catalog is not illustrated.

Note Type: With

Notes: One thin metal rod (called a “file”) 5 centimeters long.
                                       
Note Type: Citation

Notes: Allen CW. Local and Regional Anesthesia. Philadelphia: Saunders, 1914:106-119.

Note Type: Citation

Notes: Brown DL, Winnie AP. Biography of Louis Gaston Labat, M.D. Regional Anesthesia. September-October, 1992;17(5):249-262.

Note Type: Citation

Notes: Bull Soc Chimique de Paris. May 5, 1881;9:561 and 672.

Note Type: Citation

Notes: Cables HA. The use of quinine and urea hydrochloride in sciatica and allied conditions, with report of cases. Lancet Clinic. July 17, 1915;114(3):57-59.

Note Type: Citation

Notes: Crile GW, Lower WE. Annoci-Association. Philadelphia: Saunders, 1914.

Note Type: Citation

Notes: Farr RE. Practical Local Anesthesia and is Surgical Technic. Philadelphia: Lea & Febiger, 1923:40-41

Note Type: Citation

Notes: Henry Thibault [Obituary.] J Arkansas Med Soc. October, 1931;28(5):98.

Note Type: Citation

Notes: Katz J. George Washington Crile, anoci-association, and pre-emptive analgesia. Pain. June, 1993;53(3):243-245.

Note Type: Citation

Notes: Labat LG. Regional Anesthesia: Its Technic and Clinical Application. Philadelphia: Saunders, 1923.

Note Type: Citation

Notes: Parke, Davis & Company. Complete Catalogue of the Products of the Laboratories of Parke, Davis & Company. Detroit, Michigan: Parke, Davis & Company, 1922:133.

Note Type: Citation

Notes: Parke. Davis & Company. 1929-1930 Physician’s Catalog of the Pharmaceutical and Biological Products of Parke, Davis & Company. Detroit, Michigan: Parke, Davis & Company, 1929.

Note Type: Citation

Notes: Sherwood-Dunn B. Regional Anesthesia (Victor Pauchet’s Technique). Philadelphia: F. A. Davis Company, 1920: 17.

Note Type: Citation

Notes: Smith AE. Block Anesthesia and Allied Subjects. St. Louis: Mosby, 1920:245-261.

Note Type: Citation

Notes: Thibault H. Local anesthesia with quinin and urea hydrochlorid. JAMA. April 23, 1910;54(17):1375.
                                         
Note Type: Citation

Notes: https://fr.wikipedia.org/wiki/Victor_Pauchet. Accessed December 7, 2016.

Note Type: Physical Description

Notes: One box; Consisting of two parts: a base divided into six compartments, and a telescoping lid and blue-gray paper labels on the top and sides; The text panels on the front and back of the box overlap the seam where the two halves of the box meet; The front panel reads: “1-2 Dozen – No. 17 – 5 Cc. Each [new line] GLASEPTIC [new line] AMPOULES [new line] (HYPODERMIC INJECTION) [new line] Quinine and [new line] Urea Hydrochloride [new line] Each Ampoule contains 5 Cc. [new line] Solution Quinine and Urea Hydrochloride, [new line] 1 per cent. (Local Anesthetic) [new line] Guaranteed by Parke, Davis & Co. under [new line] The Food and Drug Act, June [new line] 30th, 1906. Serial No. 6 [number stamped in red ink:] 1685534 [new line] PARKE, DAVIS & CO. [new line] DETROIT, MICH. U. S. A.”; The right side panel reads:” “TO OPEN [new line] PULL THE END [new line] OF THREAD AROUND BOX”; The left side panel reads: “GLASEPTIC [new line] AMPOULES [new line] STERILIZED [new line] SOLUTION [new line] QUININE AND UREA [new line] HYDROCHLORIDE [new line] 1 %”; The back panel is headed by an illustration captioned “Breaking off long point of ampoule”, followed by: “When required for use mark the [new line] long point of ampoule with the file [new line] enclosed. Break off, insert needle of [new line] syringe and withdraw contents by [new line] pulling down piston, or, to follow an- [new line] other method, insert the broken end of [new line] ampoule into syringe from which the [new line] needle or piston has been withdrawn, [new line] then break off the short point of [new line] ampoule and the contents will readily [new line] flow into the syringe;” An illustration at the foot of this panel is captioned “To facilitate the flow of contents        into syringe break [new line] off short point of ampoule as marked.”
                                          
Note Type: Reproduction

Notes: Photographed by Mr. Steve Donisch, November 14, 2016.

Note Type: Historical

Notes: The French chemist, Driguine, first described the combination of quinine hydrochloride and urea hydrochloride at a meeting of Le Société Chimique de Paris (the Chemistry Society of Paris) on May 5, 1881. The cataloger was unable to find a published text of Driguine’s presentation, nor biographical information about him.

American physician Henry Thibault, M.D. (1877-1931) reported the use of quinine and urea hydrochloride for local anesthesia in the Journal of the Arkansas State Medical Society in 1907. He reported it again in the Journal of the American Medical Association in 1910. Injection of the agent into the sensitive, surface tissues of the body is painful. The agent is also noted for having an unusually long-lasting effect, from several hours to several days in duration. Both of these characteristics made it appropriate for Thibault’s recommended use, in abdominal surgery, among deeper, less sensitive tissues.

In 1915, the leading American surgeon, George Washington Crile, M.D. (1864-1943), strongly seconded this recommendation. This sparked rising interest over the following decades. One of several authors who credited his use of this agent to Crile was the leading French surgeon, Victor Pauchet, M.D. (1869-1936). Pauchet’s protégé, Louis Gaston Labat, M.D. (1876-1934), founded the American Society for Regional Anesthesia in 1922, and wrote the first American textbook on regional anesthesia. In addition to its use in surgery, the agent has also been used to treat a number of painful conditions, including hemorrhoids, sciatica and varicose veins. Quinine and urea hydrochloride continues in limited use today.

Note Type: Publication

Notes: Thibault H. J Arkansas Med Soc. September 15, 1907:149.
                                          
Note Type: Exhibition

Notes: Selected for the WLM website.