112 
PROPHYLAXIS OF MALARIA. 
the troops, because it would remove the greatest source of infection 
of mosquitoes and, indirectly, of the command. 
The discovery and treatment of latent malarial infections and of 
“carriers” in the command is a most important prophylactic duty, 
which should never be neglected in posts where the disease is preva¬ 
lent. This involves, of course, the microscopical examination of the 
blood of all members of the command, and, in badly infected regions, 
this examination may have to be repeated at monthly intervals, 
although the prophylactic use of quinine should render this unneces- 
sarv after the first examination has been made. In a large command 
such an examination may be impracticable, but in smaller posts the 
measure is practical and, although it involves a great deal of work, 
should be followed out where malaria is really a serious problem. 
Every patient admitted to hospital for malaria should have the 
diagnosis confirmed by the microscope, if possible, and treatment 
should be controlled by a daily examination of the blood. No patient 
should be discharged from the hospital until the peripheral blood 
is free from plasmodia except in the case of gamete carriers, who 
may be returned to duty when the gametes are reduced to less than 
1 to 500 leucocytes. 
A “ malaria register ” should be prepared for every patient, upon 
which should be entered the type of infection, the treatment given in 
hospital and ordered after leaving the hospital, the date when the 
plasmodia disappeared from the blood, the date of return to duty, 
and any other information that may be thought desirable. When 
transferred to another command, the malaria register should be sent 
to the surgeon of the post, who can then continue the treatment. 
Every patient returned to duty should be directed to report at a 
certain time for quinine in continuance of the treatment, and the qui¬ 
nine should be administered under the personal supervision of a 
medical officer, if possible. The time of reporting can be so arranged 
as to be convenient for all concerned, and each dose administered 
should be entered upon the man’s “ malaria register.” 
When soldiers suffering from latent malarial infections are dis¬ 
covered they should be placed in hospital and a most careful exami¬ 
nation be made relative to the presence of gametes in their blood. 
If gametes' are not present, they should be returned to duty as soon 
as the blood is free from plasmodia, with directions to report for fur¬ 
ther treatment; but if gametes are present, the patients should be 
treated in hospital until the gametes are reduced to less than 1 per 
500 leucocytes. The method of treating these cases has already been 
discussed in Chapter V. A “ malaria register ” should be prepared 
for these cases and used in the same manner as for acute and recur¬ 
rent infections, but the fact that the case is a latent one should be 
entered upon the register. 
