Subtertian malaria in war

Abstract

1.The well known fact that malaria may become, in endemic areas, the most important or even decisive factor in a campaign is recalled, examples from military history are given, and that the subtertian form is the most serious in this regard is emphasized.2.Some features of this form of malaria as it affects troops in equatorial regions are described and the considerable dangers, owing to peace-time therapeutic conventions and fears of imaginary “overtreatment,” of undertreatment and consequent invalidism are stressed.3.Illustrative cases are described together with experiments in thorough forms of treatment aiming chiefly at the quick and complete termination of an attack. It is demonstrated that quinine and atebrin can be combined in full doses without toxic effects.4.The efficacy and harmlessness of quinine given intravenously are described and its wider use, even in the field, is advocated, as is also that of intravenous atebrin.5.The vital importance of adequate daily drug prophylaxis throughout the stay in a subtertian area is urged, together with thorough anti-relapse treatment for all who have suffered acute attacks. The inadequacy of the popular daily 5 grains quinine is pointed out and, if quinine is going to be used for prophylaxis, the necessity for and harmlessness of 15 grains quinine a day is stated. The superiority, however, of atebrin, both for prophylaxis and anti-relapse treatment, is described and for troops on active service in subtertian areas the giving of one tablet (0·1 gramme) a day is advocated. It is suggested that, on this dosage, recrudlescences would be virtually abolished and the malaria problem greatly reduced.6.Methods of preventive treatment recently accepted by authorities are described. The desirability of educating and drilling the soldier in anti-malarial measures is emphasized.