PREVENTION OF MALARIAL FEVER 79 



to be infected, and by the use of quinine. The common 

 practice in travelling by river of tying up for the night 

 near a native village should be discontinued. In a town, 

 settlement, or permanent camp, more radical measures 

 should be instituted. 



The policy of isolation cannot be carried out fully by 

 missionaries, or by persons in charge of labour on 

 extensive works ; and in countries where native races 

 are civilized it does not tend to improve or aim at 

 improving the sanitary condition of the place, nor at 

 reducing the heavy infantile mortality always met with 

 in native races in a badly malarial country. 



Universal administration of quinine to all persons in 

 whose blood there is evidence of malarial infection and 

 to all new-comers, and visitors to a community must be 

 similarly treated before they are allowed to reside; it is 

 expensive and, except with persons under strict control,, 

 impracticable. With troops, gangs of European workmen , 

 and school children, it can be carried out successfully, 

 sometimes also in small villages or settlements. 



The methods by medicinal means, adopted or advocated, 

 for the prevention or extermination of an infection of the 

 people in a settlement fall into two groups : (i) The 

 regular daily administration of quinine, and (2) the regular 

 administration of larger doses at longer intervals. The 

 writer favours the first and advocates the administration 

 of 5 gr. of the hydrochloride every day. The object is 

 not to get rapid absorption, as is required for treatment 

 of the acute condition, but to get slow and complete 

 absorption. If taken as an uncoated tabloid during a 

 meal in any person with a healthy digestion it will be in 

 the stomach during the time when the contents are acid 

 and absorption is most rapid. In persons liable to 

 insomnia breakfast or the first heavy meal is the best 

 meal with which to take it. Few people can take more 

 than 5 gr. for prolonged periods without ill effects, but 

 it is admitted that it does not prevent infection though 

 it reduces the parasites \vell below the number required 



