attacks. On the whole, the evidence is distinctly in favour of the systematic employment of a dose of quinine as a prophylactic.
There is considerable difference of opinion and practice as to the dose and the time of administration of quinine. There are three principal methods: (a) 5 gr. every day after breakfast, (b) 10 gr. twice a week, (c) 15 gr. every tenth and eleventh day. Some prefer one method, others another; when one plan proves unsatisfactory another should be tried. If for any reason quinine is not tolerated, that individual is unsuitable for residence in malarial countries.
Other prophylactics—— Tea, coffee, and very small doses of alcohol are also decidedly of service; but they should be used in strict moderation, the last being taken only after the work of the day is over, and when there is no longer any necessity for going out in the sun. Crudeli speaks highly of lemon decoction (made as already described, p. 131) as a prophylactic; its use can do no harm, and it is a pleasant, slightly tonic, and slightly aperient beverage, well suited as a drink in hot climates. The decoction made from one lemon may be taken daily in divided doses.
Education,—— It is impossible to lay down directions for the prevention or suppression of malaria which would be applicable at all times and to all places, and under every circumstance. What might suit one set of conditions might not be appropriate under other conditions. But by one, or other, or all of the measures indicated above, much can be done to mitigate or avoid endemic malaria. Perhaps the most important initial measure in the struggle with the pestilence is the education of the inhabitants of malarial countries in the mosquito-malaria theory. Sanitary measures can rarely be carried out effectually without the co-operation of those whom they are intended to benefit; and this cannot be secured unless the rationale of their operation is understood. Therefore, those responsible for the public health in malarial districts should, by one means or another, indoctrinate the people in the mosquito-malaria theory. If he succeed in this, the sanitarian will have an easier and a more hopeful task.
