USE OF QUININE IN MALARIA 107 



The second method of combating malaria lies in 

 individual preventive measures and, to some extent, 

 anticipatory measures. So far, the most effective 

 method of killing the malarial parasites, once they 

 have gained access to the system, consists of the 

 administration of quinine. A small dose of quinine 

 daily not only kills any parasites present, but also 

 prevents the development of the parasite if it gains 

 access to the blood. Excess of quinine is to be 

 avoided, as with all other drugs. The use of quinine 

 as a preventive is necessary in highly malarious 

 districts, and when used systematically and efficiently 

 is not dangerous. But if a patient suffers from 

 constant malarial attacks in spite of taking quinine, 

 the use of the drug should be discontinued, for 

 under such conditions its use may precipitate an 

 attack of blackwater fever. The latter malady is 

 probably of malarial origin, and is present only in 

 regions of intense malaria. 



Again, personal care is necessary to avoid 

 mosquito-bites. This can be done by the use 

 of good mosquito-nets, kept in thorough repair. 

 A few years ago (1*98-1902) some members of 

 the Royal Society's Malarial Commission, investi- 

 gated some of the worst malarial districts of West 

 Africa and India without contracting infection, and 

 they consider that attention to their mosquito-nets 

 and their scrupulous use saved them. The nets 

 should be large enough to tuck well in under the 

 mattress, and should be edged with a solid web of 

 canvas or cloth, so that if a limb is pressed against 

 the net the proboscis of the mosquito cannot reach 



