(1) In the first place, common sense suggests the avoidance, in
malarious countries, of unhealthy situations, and particularly the
neighbourhood of stagnant water. Among elements of unhealthiness is next
to be reckoned the proximity of native villages, the inhabitants of
which are infected. In the tropics "no European house should be located
nearer to a native village than half a mile" (Manson), and, since
children are almost universally infected, "the presence of young natives
in the house should be absolutely interdicted" (Manson). When unhealthy
situations cannot be avoided, they may be rendered more healthy by
destroying the breeding-grounds of mosquitoes in the neighbourhood. All
puddles and collections of water should be filled in or drained; as a
temporary expedient they may be treated with petroleum, which prevents
the development of the larvae. When a place cannot be kept free from
mosquitoes the house may be protected, as in the experiments in Italy,
by wire gauze at the doors and windows. The arrangement used for the
entrance is a wire cage with double doors. Failing such protection
mosquito curtains should be used. Mosquitoes in the house may be
destroyed by the fumes of burning sulphur or tobacco smoke. According to
the experiments of Celli and Casagrandi, these are the most effective
culicides; when used in sufficient quantity they kill mosquitoes in one
minute. The same authorities recommend a powder, composed of larvicide
(an aniline substance), chrysanthemum flowers, and valerian root, to be
burnt in bedrooms. Anointing the skin with strong-smelling substances is
of little use in the open air, but more effective in the house;
turpentine appears to be the best. Exposure at night should be avoided.
All these prophylactic measures are directed against mosquitoes. There
remains the question of protection against the parasite. Chills are
recognized as predisposing both to primary infection and to relapses,
and malnutrition is also believed to increase susceptibility; both
should therefore be avoided. Then a certain amount of immunity may be
acquired by the systematic use of quinine. Manson recommends five to ten
grains once or twice a week; Ross recommends the same quantity every day
before breakfast. There is some evidence that arsenic has a prophylactic
effect. An experiment made on the railway staff at Bovino, a highly
malarious district on the Adriatic, gave a striking result. The number
of persons was 78, and they were divided into two equal groups of 39
each. One group was treated with arsenic, and of these 36 escaped
altogether, while three had mild attacks; the remaining 39 who were not
treated, all had fever. In a more extended experiment on 657 railwaymen
402 escaped. This was in 1889; but in spite of the encouraging results
the use of arsenic does not appear to have made any further progress.
Experiments in immunizing by sero-therapeutic methods have not as yet
met with success.
Administrative Measures.
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