100 
PROPHYLAXIS OF MALARIA. 
three weeks before one can expect to reduce the number of gametes 
to a safe margin in the majority of cases they have observed. Of 
course the dosage may be reduced if the gametes are present in small 
numbers, and Thomson recommends a daily dose of 1.3 grams (grs. 
xx) for the same period of time in such cases. 
The same treatment should be given the gamete carriers dis¬ 
covered in making a malarial survey and in whom the infection is 
latent. In the case of troops, every soldier, who is not in hospital and 
who shows gametes in his blood, should be placed there at once, 
carefully screened, and treated with quinine in the dosage recom¬ 
mended until his blood shows less than 1 gamete per 500 leucocytes. 
There is no other alternative than the thorough treatment of these 
“carriers” in camps and posts where anophelines can not be elimi¬ 
nated, and the only way to treat them is to confine them in a screened 
room and to give quinine in large doses until the blood examination 
shows that it is safe for them to return to duty. If allowed at 
liberty, these men furnish a constant source of infection to the re¬ 
mainder of the garrison and render other prophylactic measures less 
useful than they otherwise would be. 
The treatment of gamete carriers must be controlled by the fre¬ 
quent microscopic examination of the blood, as in no other way can 
we be sure when the patient is ready to be returned to duty. Here, 
again, we see the absolute necessity of every sanitary officer being* 
familiar with the use of the microscope in the diagnosis of malaria 
and of the morphology of the plasmodia and the methods of demon¬ 
strating them. 
The treatment of initial and recurrent infections in prophylaxis .— 
In the preceding discussion of gamete carriers it has been shown that 
the gametes do not develop until the infection has lasted for several 
days; that after they do develop, the patient becomes a “ carrier ” of 
malaria; and that in order to render him harmless he must be put 
upon sick report, confined in a screened room, and given large doses 
of quinine for practically three weeks. This is absolutely necessary 
from a prophylactic standpoint, but a still more important pro¬ 
phylactic measure is to so treat malarial infections that the gametes 
do not develop. Every gamete carrier is an evidence of either im¬ 
proper treatment or of no treatment, and if of improper treatment, 
an evidence of ignorance or carelessness on the part of the attending 
physician. In other words, the proper treatment of the initial at¬ 
tack of malaria would have prevented the formation of gametes , 
and there would have been no “ carrier ” of the disease. In the 
prophylaxis of malaria the proper treatment of acute infections is 
of vast importance, an importance that has not been realized by 
the profession, and it is sad, but true, that a very large proportion 
of the malaria present in the majority of localities is directly due 
