THE DRUG TREATMENT OF MALARIA, SUPPRESSIVE AND CLINICAL

1. Efficacy of Atabrine, Quinine and Plasmochin.—  a. Available evidence indicates that atabrine is as effective as quinine (or more so), both in suppressive use and in the treatment of clinical attacks. No available drug or plan of administration can be expected to prevent relapses in all cases (see paragraph 6). Recent studies have shown that the plasma level of the drug is fundamental in determining its efficacy. Under ordinary conditions the rates of absorption of the two drugs are not significantly different. Quinine is localized in the tissues to a smaller extent than atabrine, and effective plasma concentrations, therefore, are usually attained shortly after the beginning of its administration. Atabrine, on the other hand, at first is taken up to a much larger extent by the tissues, so that effective concentrations in the plasma are reached only as certain tissues become more or less saturated. On the usual