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of  quinine  are  taken  in  the  quantities  ordered  by  the  Medical  Officer. 
By  this  means  recurrences  v/ill  be  rendered  less  frequent  and  chronic 
infections  with  enlarged  spleen  will  disappear. 
X.  ANTI-MALARIAL  ORGANISATION 
1  have  thus  gone  somewhat  fully  into  the  preventive  measures 
which  experience  has  shown  to  be  beneficial  as  regards  the  reduction 
of  malaria,  and  have  indicated  those  which  are  specially  applicable 
to  Jamaica ;  and  the  question  of  the  machinery  by  which  they  are 
to  be  carried  out  must  now  be  considered.  If  any  plan  of  campaign 
is  to  be  carried  out  persistently  and  systematically,  some  form  of 
organisation  must  be  provided,  and  this  applies  equally  to  the  war 
against  disease.  Our  efforts  must  be  properly  directed  if  they  are 
to  be  effective. 
But  the  machinery  must  not  be  complicated  or  expensive,  and 
the  following  brief  sketch  indicates  the  lines  which  in  my  opinion 
should  be  followed. 
1.  First  there  should  be  a  Central  Malarial  Board  to  sit  in 
Kingston.  It  should  consist  of  members  from  various  localities, 
and  the  medical  profession  should  be  largely  represented  on  it.  No 
doubt  the  secretarial  work  of  the  Board  could,  with  advantage,  be 
done  by  the  Medical  Department. 
The  Board  would  formulate  a  plan  of  campaign,  consider  the 
works  and  methods  to  be  adopted  in  various  localities,  estimate  cost, 
consider  the  legislation  required,  and  receive  and  collate  all  statistics 
and  reports  as  to  work  done. 
2.  Local  Boards  to  report  and  recommend  to  Central  Board,  and 
to  carry  out  the  measures  decided  on.  Their  Medical  Officer  should 
be  ex-officio  a  member  of  the  Local  Board. 
3.  Staff  of  Local  Boards  : — 
(a)  Medical  Officer.  The  question  as  to  whether  this  work  can 
be  carried  out  by  the  District  Medical  Officer  will  have  to  be 
considered.  In  some  districts  it  would  be  an  advantage,  in  others  it 
seems  to  me  that  their  time  is  already  so  much  occupied  with  other 
duties  that  they  would  be  unable  to  give  the  necessary  supervision. 
The  duties  of  the  Medical  Officer  would  be  general  inspection  of  the 
malarial  district,  general  supervision  of  the  men,  medical  examination 
