104 
PROPHYLAXIS OF MALARIA. 
the Study of Malaria in Italy, led by Celli. In that country quinine 
is sold by the State to those able to purchase and distributed free 
to those unable, and Celli claims that since the gratuitous distribu¬ 
tion of quinine by the Government the mortality from malaria in 
Italy has diminished over 75 per cent and the morbidity in propor¬ 
tion. While other methods of prophylaxis, as screening and drain¬ 
age, have been used, Celli regards the prophylactic use of quinine 
as altogether the most efficient, and believes that it is the only 
method that can be relied upon in Italy to control malaria. In view 
of the great importance of his work I shall give a brief resume of 
the results obtained and his commentaries upon them. 
In the following table Celli 56 gives the results of quinine prophy¬ 
laxis in the army, in which the morbidity has been reduced from 
27.4 per cent to about 5 per cent by the use of this method: 
Table YIII .—Malaria in tlic Army. 
Year. 
Number 
of men. 
Number 
of cases 
(percent). 
Relapses. 
Initial 
attacks. 
Remarks. 
1902. 
199,253 
206,468 
210,637 
27.44 
21.41 
6.03 
No quinine. 
Quinine begun. 
1903. 
24.14 
17.85 
6. 28 
1904. 
19.21 
12.71 
6.50 
1905 . 
218,409 
21.52 
13.04 
8.48 
1906. 
211,245 
202,320 
216,679 
228,951 
234,104 
IS. 99 
12.67 
6.32 
Quinine. 
Do. 
1907. 
12.46 
7.96 
4.50 
1908. 
S. 04 
5.19 
2.85 
L>0. 
1909 . 
6.96 
4.72 
2.24 
Do. 
1910 . 
5.10 
3.23 
1.87 
Do. 
1911. 
233^517 
4.90 
3.04 
1.86 
Do. 
From this table it will be noted that there has been a steady reduc¬ 
tion in the number of initial attacks and the number of recurrent 
cases of malaria in the Italian army ever since the adoption of pro¬ 
phylactic quinine, in 1903, until at the end of 1911 the percentage 
of cases of malaria in the entire army was only 4.9 per cent, and this 
despite the fact that the troops were often stationed in the most 
malarious parts of the country. 
Celli 57 gives the results of quinine prophylaxis in the penal colony 
of Castiades in the following table: 
Table IX. — Malaria in the penal colony of Castiades , Sardinia. 
Year. 
Popula¬ 
tion. 
Quinine 
used, in 
kilograms. 
Num¬ 
ber of 
cases. 
Per cent. 
Remarks. 
1904. 
748 
None. 
694 
92 
No quinine. 
1905. 
861 
13,674 
731 
84 
Little quinine. 
1906. 
807 
15,080 
390 
48 
Quinine. 
1907. 
795 
40,230 
132 
16 
Daily quinine distributed. 
1908. 
700 
35, 400 
97 
13 
Do. 
1909. 
691 
32,000 
64 
9 
Do. 
1910. 
655 
15,280 
139 
19 
Only curative quinine. 
1911. 
540 
25,360 
37 
6 
Prophylactic quinine. 
