224 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
PROPHYLAXIS 
At the outset we shall divide the prophylaxis of malaria under two heads : — 
I. The prevention of malaria in native communities. 
1. The prevention of malaria in Europeans. 
The two problems are essentially different, and no confusion should ever exist 
in our minds as to what any given anti-malarial measures are intended to achieve, 
whether increased health of resident Europeans or diminution of native malaria. 
I. The Prevenion of Malaria in Native Communities 
Prophylactic measures applicable to the average native of tropical Africa are, 
for many years to come, beyond discussion. The vast bulk of African natives are 
completely beyond any sanitary control whatever. In some large towns a measure 
of control does exist, e.g., Freetown, Lagos, Accra, Cape Coast Castle, and a few 
others. In these only has one the least hope of achieving any result. 
Methods of malarial prevention applicable to large native communities seem 
confined to some form of Anopheles destruction, either by superficial drainage or by 
the continuous labours of a mosquito brigade. The administration of quinine, 
advocated by Koch, though so effective under the conditions at Stephansort, could 
not, we feel certain, be applied with any measure of success even in Freetown or 
Lagos. With regard to Anopheles destruction, it drainage can be carried out, it 
would, in our opinion, be successful in preventing native malaria. 
2. The Prevention of Malaria in Europeans 
In 1900, working on the Gold Coast, we advocated the protection of Europeans 
in Africa as being at present the proper and legitimate object of our limited resources 
in Africa. We gave reasons for believing that a system of segregation from the 
native, carried out as opportunity offered, would be far more effective than any other 
prophylactic measure within our power. We have already seen that the malarial fever 
to which the European is subject is due to the tact that he lives amidst the natives, 
or with the native at his door. We would emphasize again the fact that these con- 
ditions have impressed themselves upon us so vividly, because our experience of them 
has not been that of a passing observation, but one derived from actually living under 
them. We have enjoyed the hospitality of very many Europeans, and have slept in 
the bungalows and quarters of officials, railway engineers, missionaries, settldf,s s traders, 
in quarters in the centre of native camps, always with the inevitable native hufs in the 
compound, and in all, these conditions held good. Realizing the danger of sleeping 
under such conditions, we succeeded in preserving our health only by most constant 
and unremitting care in the use of personal precautions. Such precautions we, how- 
ever, found were generally so irksome that men preferred to run the risk of infection 
rather than bestow the necessary attention to them. Although we used mosquito 
nets we found it necessary to employ an extraordinary and troublesome degree of 
care in their use in such conditions as are usual in African up-country stations, and 
