Action of Cinchona Alkaloids in Malaria*

Abstract

ALTHOUGH three centuries have elapsed since cinchona bark was introduced into European medicine for the treatment of malaria and it is nearly a century since the last of the four alkaloids—quinine, quinidine, cinchonine, and cinchonidine—which form the active constituents of the bark was discovered, there are still numerous problems to be settled in connexion with the use of the bark and its constituents in malaria. Until recently, chemotherapeutical work in this disease has been hampered by the fact that the relative values of drugs could only be investigated by extensive clinical trials in malarial countries. Much work of this kind has been done in India and Malaya by MacGilchrist, Acton, Fletcher, Sinton, and other British experts in tropical medicine, mainly to ascertain whether the present policy of concentrating on quinine as the only valuable cinchona alkaloid for the treatment of malaria is sound. Work of this kind is expensive and difficult, and final conclusions have not yet been reached.