The Treatment of Malaria

Prior to the discovery of the sulfonamides and antibiotics, few diseases, if any, responded more favorably to a drug than did malaria to quinine. The importance of this drug to civilization can never be overestimated. Nevertheless, over the centuries the natural incidence of the disease was not altered by quinine or later by quinacrine (Atabrine) because of a common shortcoming, the inability to eradicate an infection completely. Their usefulness was largely limited to the suppression of the clinical manifestations of the infection or the early termination of the acute attack. However, since malaria is chiefly characterized by its tendency to relapse, particularly vivax infections which is the more prevalent variety, the constant search by scientists for improved compounds continued. These efforts were relatively meager and sporadic until the Germans began a systematic and intensive program following World War I. From this effort they were rewarded with the discovery of quinacrine, an important substitute for quinine, and pamaquine, potentially a curative but relatively toxic compound.