William Hall Holden, M. D. 
755 Park Ayenite 
New York 21, N, Y 
February 11, 1947 
V c. I IVIOK.. 
L'i 
813 1947 
ie 
Dear Alex: 
Just to make sure that you have accurately, the dosages for tt 
administration of Aralen allow me to reiterate the following, 
/For the suppression of malaria single weekly doses have been 
demonstrated. A dose of 0.5 gm; (two tablets) given on exactely the same 
day each week,is recommended. For the treatment of an acute attack in an 
adult an initial dose of 1 gm. ( four tablets) followed by an additional 
0.5 gm. { two tablets ) after from six to eight hours and a single dose 
of 0.5 gm. ( two tablets ) on each of two consecutive days (total 2.5 gm. 
equal 10 tablets in three days) is sufficient to produce prompt disappearance 
of symptoms and of parasitemia. This regimen eradicates infection due to 
?. falciparum and terminates the acute attack of P. vivax infection. In the 
latter, freedom from clinical attacks may be maintained thereafter by adminis¬ 
tration of suppressive doses (0.5 gm. once a week)/] 
This may be a little different that I gave you at the dinner but 
it all sums up to taking sufficient drug to build up a certain concentration 
m the blood. So far as Aralen is concerned and its merits as compared to 
Atabrine, clinical experience has shown that it is about three times more 
effective than Atabrine without the disagreeable nature of turning a person 
yellow on long administration. However, I believe that Atabrine is almost 
as effective when used in a similar way. Of course, with Atabrine we usually 
give for treatment three (1|- grs. each) tablets daily for five days, skip a 
week and repeat. For suppression doses we usually took one tablet for three 
days,then skip three days and repeat. 1 am giving you this information in 
case you have Atabrine with you. 
Of course, the most important treatment in malaria is not to let 
tne mosquito bit you and you can do this by getting under the net after 
sundown and by making sure there are no mosquitos inside the net.J Here’s 
hoping you will have a very successful trip. I envy you in being able to 
get away to get back to that heavenly country. 
Kindest personal regards 
0 
v» 
7 ft- 
// 
7 ’■*. 
William Hall “olden, M.D. 
WHH 
Dr. Alexander Wetmore 
Smithsonian Institute 
Washington, D.C. 
