PROPHYLAXIS OF MALARIA. 
105 
In regard to this really remarkable reduction in the number of 
cases of malaria among the prisoners in this institution from 92 
per cent to G per cent, Celli says: 
It was the prophylactic administration of quinine alone that produced the 
miracle of diminishing malaria to 8 or 9 per cent. 
In the whole of Italy the mortality from malaria has decreased 
from 21,000 deaths in 1887 to about 3,000 in 1908, quinine pro¬ 
phylaxis having been established about 1905, and Celli says: 
Beyond doubt the greatest and most persistent decrease of mortality from 
malaria in Italy was due to the increased consumption of quinine. 
In view of these results it is useless for the opponents of quinine 
prophylaxis to claim that it is of little value in the prevention of 
malarial infections, for they absolutely demonstrate that the method, 
if faithfully followed, is of the very greatest service, and similar 
results have been obtained by other observers. 
In the Dutch Indies, Bisdom 59 has reduced the percentage of 
Europeans infected from 80 to 20 per cent, and the percentage of 
infections in natives from 71 to less than 17 per cent, by the use of 
quinine in prophylaxis and treatment, and states that the use of this 
drug has been the most important factor in diminishing the inci¬ 
dence of malaria in the Netherland Indies. In Corsica, 60 Leger has 
found quinine prophylaxis very effective, the blood index among the 
inhabitants of Casabianca, for example, falling from 42,85 per cent 
to 7.14 per cent after the exhibition of 0.20 gram of quinine daily, 
and the Sergents 61 have reported excellent results in Algeria. 
The impression that quinine prophylaxis must extend throughout 
the year in malarial regions is erroneous, for in almost every locality 
there is a malarial season, and it is only just prior to and during this 
period of seasonal prevalence that it is necessary to use the drug in 
this manner. Prophylaxis with quinine should be begun about a 
month before the malarial season begins and continued for about 
the same time after it ends. In some localities, of course, the drug 
will have to be given the greater part of the year, but in most places 
it will be found that it can be omitted for weeks, or even months, 
with advantage. 
In conclusion, it may be stated that in quinine prophylaxis we 
possess a most valuable method of preventing malarial infections, 
and one that can be easily applied in the military service, but it 
should not be used to the exclusion of the more permanent methods 
depending upon the destruction of the mosquito,where such methods 
can be instituted. Although, as Celli says, 62 “those who take 
quinine daily, having a certain quantity of it in the circulating 
blood, can fearlessly subject themselves to the inoculation of blood 
