88 
PROPHYLAXIS OF MALARIA. 
given in the manner here recommended does prevent malarial infec¬ 
tions, although some authors, as Thomson, would have us believe 
that much larger doses are necessary. It is true that larger doses 
have to be used in the treatment of the infected, but for the pre¬ 
vention of the disease in the uninfected the doses recommended will 
be found efficient in the very great majority of instances. 
As a prophylactic quinine must be administered by the mouth. 
When given in this way it may be administered in the form of a 
solution, pills, tablets, capsules, wafers, troches, and confections. 
In the military service the solution and tablets are about the only 
practicable forms where large bodies of men are to be treated, and in 
the field the cheapest and most useful method of dispensing the 
drug is in the form of tablets containing the required dose. Now¬ 
adays excellent tablets may be obtained, but even so, the utmost care 
must be used to see that quinine is really being supplied and that the 
tablets are soluble. We are all familiar with the insoluble quinine 
tablet and pill, but at the present time the tablets upon the market 
are satisfactory in this respect and will be found efficient. 
The solution of quinine may be employed in camps and posts and 
possesses the advantage that the drug is more readily and quickly 
absorbed and there is little chance of the soldier evading the taking 
of the dose. The solution is prepared by dissolving 0.32 grams (5 
grains) of quinine sulphate in 4 c. c. (1 dram) of distilled water to 
which one drop of concentrated hydrochloric acid has been added. 
A large amount of this solution can be made up at one time, as it 
keeps well, and can then be dispensed as needed. 
In order to be effective the administration of quinine as a pro¬ 
phylactic must be under the direct personal supervision of a medical 
officer, and this duty should not be delegated to any subordinate, but 
should be considered one of the most important 'personal duties that 
the sanitary officer is called upon to perform. Many of the reported 
failures of quinine prophylaxis in troops have been due to the rele¬ 
gation of this duty to careless subordinates and their inefficient 
application of the particular method selected, with the result that 
the method has been condemned without a fair trial. 
The proper treatment of malarial infections and of “ carriers ” in 
the prophylaxis of the disease. —It is well known that after an attack 
of malarial fever lias persisted for from 8 to 10 days or more, pro¬ 
vided insufficient quinine has been given, there develop in the blood 
of the infected individual forms of the plasmodia known as gametes , 
which are capable of infecting anopheline mosquitoes, and eventually 
of rendering these insects capable of transmitting malaria to man. It 
is evident that if these forms could be prevented from developing 
mosquitoes could not become infected and malaria could not be trans¬ 
mitted. It follows, therefore, that if quinine will prevent the for- 
