86 
PROPHYLAXIS OF MALARIA. 
Methods of administration and dosage .—In discussing this ques¬ 
tion two problems must be considered, i. e., the best method of admin¬ 
istration of quinine to prevent infection and the dose required and 
the best method of curing initial infections and carriers of the disease. 
The latter will be discussed under a separate heading, and I will here 
give the various methods of quinine prophylaxis that are intended to 
directly protect the individual from infection by the plasmodia. 
All methods of quinine prophylaxis may be divided into two 
classes—i. e., those in which the drug is administered daily and 
those in which the drug is administered at larger intervals. The 
latter methods are all aimed at doing away with the irksome 
daily administration, but all have the fault that one must remem- 
ber the days upon which quinine should be given, with the result that 
many doses are missed, while there is good evidence showing that 
none of them are as effective in prophylaxis as the daily administra¬ 
tion of the drug. 
The following are the chief methods of using quinine as a prophy¬ 
lactic, together with the doses advocated: 
Celli’s method .—The daily administration to adults of 40 centi¬ 
grams (6 grains) of quinine, 20 centigrams in the morning and 20 
centigrams in the evening. To children, 20 centigrams (3 grains), 
10 centigrams in the morning and 10 centigrams in the evening. 
Sergent's method .—The administration in one dose, daily, of 20 
centigrams (3 grains) of quinine. 
Zieman and Nocht's method .—The administration of 1 gram (15 
grains) of quinine every fourth day, given in 0.25-gram (4-grain) 
doses. 
Plehn's method .—The administration of 1 gram of quinine (15 
grains) every seventh day. 
Koch's method .—The administration of 1 gram (gr. xv) every 
sixth and seventh, seventh and eighth, eighth and ninth, or ninth 
and tenth days, according to the severity of the infections present. 
While our choice of the exact method of giving quinine as a pro¬ 
phylactic will be influenced in the military service by local conditions, 
I believe that the method of Celli, supported as it is by years of 
success in practice, will be found the most efficient one for adoption 
by troops campaigning in a malarial country. The giving of the 
drug in morning and evening doses would probably often have to be 
replaced by the practice of giving the entire amount in one evening 
dose, but the daily administration of the drug I believe to be essen¬ 
tial to the success of malarial prophylaxis in an army in the field. 
For such service, then, I would recommend the administration of 
40 centigrams (6 grains) of quinine sulphate to every soldier every 
clay , preferably in an equal morning and evening dose, but if this is 
impracticable, in a single dose at evening. 
