MALARIA 107 



drinks to acid perspiration. In hot stage, vinegar or its equivalent 

 to the forehead ; for headache, aspirin can be used but in severe cases 

 heart failure may be caused by it. Caffeine is good in small doses, 

 2-3 grains. In the sweating stage remove all blankets, damp 

 clothing and bedding, then administer tepid sponging, iced soda 

 water, &c. For — 



Vomiting: iced champagne; mustard leaf to pit of stomach; chloro- 

 form and morphine mixture, stomach lavage. 



Hiccough : mustard leaf, codeine, morphia. 



Cough: codeine and morphia. 



Constipation : calomel, 1-3 grains, followed by saline. 



Hyperpyrexia: cold sponging, cold packing, cold baths, cold 

 enemata. If the temperature is kept within limits for a few hours the 

 quinine will have a chance to act. 



Algidity: salines given hypodermically, intramuscularly, intra- 

 venouslv or per rectum. Warm applications to body, oxygen inhala- 

 tions, ether and strychnine. 



Hcrmorrhages : calcium lactate, adrenalin, salines. 



Big spleen : counter-irritants, saline aperients, quinine, iron and 

 arsenic. 



Convalescence : Give quinine for three months, iron and arsenic for 

 two months. If the attack has been very serious send patient to a 

 cool climate. 



PROPHYLAXIS. 



It is most essential that all the scientific methods of prophylaxis 

 should be carried out. By them the death-rate, case incidence, illness 

 and mortality from complications, as well as the disease and the 

 expense to employers of labour, are enormously decreased. 



The work of Colonel Gorgas and his Sanitary Staff at Panama for 

 the abolition of Yellow Fever and the enormous decrease of Malaria 

 is too well known to be repeated here. This work was made possible 

 by the sanitarian. The monev spent in such work is insignificant 

 when compared with the work achieved and the lives saved. 



Prophylactic measures against Malaria may be summarized under 

 two heads : — 



(i) Protection against mosquito bites. 



(2) Mosquito reduction. 



These will now be dealt with. 



(A) PROTECTION AGAINST MOSQUITO BITES. 



(i) Mosquito nets must be used invariably, twenty-five strands to 

 the inch, which will keep out the Simulid^ also. The nets should be 

 tucked under the mattress and not allowed to fall looselv on the floor. 



