In November 1947, Stafford Cripps, the UK’s Minister for Economic Affairs, told a conference of Britain’s governors in Africa that with the sterling area’s dollar deficit running at £600 to £700 million a year ‘we should increase out of all recognition the tempo of African economic development’, boosting production of anything that ‘will save dollars or will sell in a dollar market’. 1 Here was evidence that in the UK’s post-war reconstruction crisis ‘more completely than ever before economics and empire had come together’. 2 The same applied for Europe’s next two largest maritime empires. ‘One of the assumptions underlying policy in the Fourth Republic was that the French Empire [albeit restyled ‘Union’] … could be developed economically in order to strengthen France’s position in the postwar world.’ 3 Meanwhile, in The Netherlands where ‘total regeneration was the order of the day, as to the Dutch East Indies [Indonesia] there was only one thought: restoration of the ties between mother country and the colonies, and restoration of the triangle of commerce, Netherlands-Indonesia-America, which according to the experts was essential for the revival of the Dutch economy.’ 4 Although the post-war ‘second colonial occupation’ was partly concerned with issues of international prestige (particularly for France and Holland), a prime focus of this chapter is the relationship between the development drive overseas and the most pressing international economic issue shared by London, Paris, and The Hague, namely the dollar shortage. In the short term, at least, it will be argued that these were largely successful strategies. But, at the same time, the latter part of this chapter demonstrates how the ‘new imperialism’ of the immediate post-war period exacerbated problems of colonial political management. Moreover, imperial policies and their unwitting consequences provoked new tensions within European imperial and colonial elites, and especially alienated and disillusioned key metropolitan business leaders.
This chapter demonstrates that economic tensions between Kuala Lumpur and Singapore bedevilled the period of merger from September 1963 to August 1965. Revising the standard explanation in the existing historiography that ethnic tensions lay at the heart of Singapore's expulsion from the Malaysian federation, this chapter shows that economic differences were central to Singapore's exit.
Department of Plastic and Reconstructive Surgery, Sandwell General Hospital, West Bromwich, West Midlands, United, Kingdom Correspondence to Dr. White, 26 Rowood Drive, Solihull, Birmingham, West Midlands B92 9LU, United Kingdom, [email protected]
Acute pharmacokinetics of intravenously infused quinine were studied in 25 patients with cerebral malaria and 13 with uncomplicated falciparum malaria. In patients with cerebral malaria receiving the standard dose of 10 mg/kg every eight hours, plasma quinine concentrations consistently exceeded 10 mg/liter, reaching a peak 60 ± 25 hours (mean ± 1 S.D.) after treatment was begun and then declining. Quinine total clearances (CI) and total apparent volumes of distribution (Vd) were significantly lower than in uncomplicated malaria (CI, 0.92 ± 0.42 compared with 1.35 ± 0.6 ml/min/kg, p = 0.03; Vd, 1.18 ± 0.37 compared with 1.67 ± 0.34 liter/kg, p = 0.0013). There was no significant difference between the two groups in elimination half-times (t/2) or renal clearances (Cu) (t/2, 18.2 ± 9.7 compared with 16 ± 7.0 hours; Cu, 0.21 ± 0.16 compared with 0.21 ± 0.08 ml/min/kg). In nine patients studied following recovery, CI (3.09 ± 1.18 ml/min), Vd (2.74 ± 0.47 liter/kg), and Cu (0.53 ± 0.22 ml/min/kg) were significantly greater (p < 0.0004), and t/2 was significantly shorter (11.1 ± 4.1 hours, p = 0.006) than during the acute illness. Cu accounted for approximately 20 percent of CI in all groups. Renal failure did not alter the disposition kinetics in cerebral malaria. There was no clinical or electrocardiographic evidence of cardiotoxicity and no permanent neurotoxicity. Quinine toxicity in cerebral malaria has probably been overemphasized. The benefits of high plasma concentrations in the acute phase of this life-threatening disease appear to outweigh the risks, particularly in view of the increasing resistance of Plasmodium falciparum to quinine in Southeast Asia.
No abstract is provided for this article.
In eastern Thailand, 14 adults with moderately severe falciparum malaria were treated with intravenous amodiaquine dihydrochloride, loading dose 10 mg base/kg infused over 4 h followed by three further intravenous infusions of 5 mg base/kg at 24, 48, and 72 h. All patients were clinically cured—mean fever clearance time 37·8 h (range 24-60), mean parasite clearance time 64·9 h (18-164). There were no serious toxic effects. 33 patients aged over 5 years with uncomplicated falciparum malaria were given oral amodiaquine dihydrochloride (mean total dose 41 mg base/kg over 3 days) combined with erythromycin estolate (mean dose 48 mg base/kg daily for 5 days). 2 patients failed to respond. In the other 31 patients mean fever clearance time was 55·9 h (range 10-104) and mean parasite clearance time was 65·4 h (40-120). In both studies, more than half the patients followed-up had recurrent parasitaemia but reinfection could not be excluded. Parasites isolated from 18 patients were highly resistant to chloroquine in vitro.
