298 BACTERIOLOGY FOR NURSES 



The use of quinine as a prophylactic on a large scale is a com- 

 paratively recent measure. The Italian Government in 1902 

 commenced its sale at cost price to those communities which agreed 

 to distribute it gratuitously to individuals unable to purchase it. 

 The result has been remarkable. During the ten years previous 

 to 1902 the deaths from malaria averaged 14,048 annually, whereas 

 during the ten years following the average fell to 3853. 



The administration of quinine to healthy individuals does 

 not prevent infection ; it destroys the young parasites in the blood 

 after infection has occurred. Its use is advantageous in that it 

 is cheap and its action is prompt. It can, however, only be consid- 

 ered as a tentative measure and cannot supplant mosquito sup- 

 pression. 



BLACKWATER FEVER 



The condition known as blackwater fever occurs especially 

 amongst Europeans in tropical countries. It is characterized 

 by fever, hemoglobinuria, and delirium, frequently ending in coma 

 and death. The etiology of the disease is not at all clear. A 

 few observers consider it an independent disease; the majority, 

 however, believe it to be the terminal stage of a malarial infection. 

 The fact that an attack is often precipitated by the administra- 

 tion of quinine has led to the suggestion that the drug may be the 

 responsible agent for the marked destruction of red blood cells 

 which characterizes the disease. In the great majority of cases, 

 however, if the malarial organisms cannot be found in the blood 

 there is evidence of the patient having suffered from repeated 

 attacks of malaria. 



CILIATA 



The Ciliata are the highest type of protozoa. They may be 

 distinguished from the other groups by the presence of cilia dis- 

 tributed over the cell, which serve as organs of locomotion and 

 which give to the group its name. They possess special structures 

 for the reception of food and also for excreting waste products. 



Only one of the ciliates, Balantidium coli, has been found patho- 



