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March 4, 1968

Chloroquine-Resistant Falciparum Malaria

JAMA. 1968;203(10):893. doi:10.1001/jama.1968.03140100075026

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To the Editor:—  It was with great interest I read the letters on chloroquine-resistant falciparum malaria (202:989, 1967). Before returning to private practice, I was chief of medicine at an Army evacuation hospital in Vietnam for seven months. Having seen literally hundreds of patients with falciparum malaria, I am writing to support the statements of Blount, et al. The status of a falciparum malaria patient is difficult to evaluate, and postponing the use of quinine in these patients is quite dangerous when they have come from an area where resistant strains occur. Prior to the time when the urgent need for quinine in such cases was appreciated, I personally saw one patient go into blackwater fever before the drug was given.It is mandatory that physicians in the United States understand that the early initiation of quinine will prevent far more disease complications than quinine itself will induce... when