154 



Thomson (D.). The Diagnosis and Treatment of Malarial Fever. — Jl. 

 R.A.M.C., London, xxix, no. 1, July 1917, pp. 1-37. 



Quinine propliylaxis, or the administration of small doses of the 

 drug to uninfected subjects in a malarial community in order to safe- 

 guard them against infection from mosquitos, was formerly considered 

 to be the best means of preventing or reducing the incidence of malaria. 

 Anti-mosquito measures have, however, proved to be vastly superior, 

 since mosquitos are in themselves a pest and are capable of carrying 

 diseases other than malaria. It has been shown that the gametes or 

 sexual forms of the malarial parasite alone have the power of rendering 

 the mosquito infective to human beings. When the Anopheline sucks 

 the blood of a human patient containing these, fertilisation occurs in 

 the stomach of the mosquito, which becomes infective to human 

 beings about twelve days later. If, however, the mosquito sucks the 

 blood of a human patient containing only the asexual or fever forms 

 of the parasite, and no gametes, it will not become infected. Gametes 

 are not always found in the blood of every malaria patient ; in early 

 acute cases they are comparatively rare. They do not cause any 

 fever symptoms and a patient may feel quite well and yet have large 

 numbers in his blood, since they are usually associated with small 

 numbers of the asexual forms insufficient to cause any fever. It 

 appears that when the asexual form of the parasite begins to find life 

 difficult owing to occasional doses of quinine or to the development of 

 natural resistance, it transforms into the sexual type and remains 

 passive awaiting transference to another host, i.e., the mosquito. 

 Hence the danger of administering small doses of quinine to prevent 

 infection, for, though it may have this effect in certain cases, in others 

 the disease may be rendered latent and " gamete carriers " produced. 

 The most reasonable and scientific course is to carry out anti-mosquito 

 measures as far as possible and to treat early and thoroughly every 

 malarial patient by a continuous course of quinine of 30 grains every 

 day for three weeks, by which means the gametes are destroyed and 

 another link in the perpetuation of the disease is broken. 



McDonnell (R. P.) & Eastwood (T.). A Note on the Mode of 

 Existence of Flies during Winter. — Jl. R.A.M.C., London, xxix, 

 no. 1, July 1917, pp. 98-100. 



Investigations undertaken with a view to determining how the 

 generation of flies is linked up from season to season are described. 

 The fact that the search for hibernating flies has not resulted in their 

 discovery seems to discount the generally accepted view that they 

 survive throughout the winter in this stage. A heap of old manure, 

 covered with grass and weeds, that had been lying untouched since 

 the previous October, was investigated in March, and living larvae 

 were found at a depth of three feet. In the same month they were 

 found at a depth of two feet in a mixture of dry earth and human 

 excreta covered with six inches of earth which had been made the 

 previous September. Pupae that had evidently migrated in the 

 larval state from these heaps were found at a distance of two feet, 

 lying about an inch below the ground surface. The larvae, when 

 removed from the heaps and placed in a warm room, pupated within 



