(90)
Enlargement of the spleen might be regarded as a rough test in ascertaining
the people who had previously suffered from malaria, and all such people
would be treated by the method already described under the term "disin-
fection of the infected." In addition these people and all other inmates
would receive during the malarious season prophylactic doses in the manner
already described.
3. Prophylaxis for communities.-No system of prophylaxis can be con-
sidered entirely satisfactory which aims at the protection of only a few,
however important those few may be, while it leaves the great mass of the
inhabitants of a place in the same condition The object of a good malarial
prophylaxis should be to render everyone less liable to contract malaria, to
transform, in fact, a malarious place into a healthy one.
How can we set about this problem ?
We know that if we can exterminate all malaria-carrying mosquitoes
from the place or if we can eradicate all malaria parasites in infected
individuals we shall entirely get rid of malaria there, and one or both of
these methods must be attempted.
The suppression of Anopheline mosquitoes.-At the outset of our neces-
sarily very brief and inadequate account of the measures necessary for the
suppression of Anopheline mosquitoes it must be stated that in places which
can justly be called malarious the task of reducing the number of these insects
to an extent sufficient to lessen materially the prevalence of malaria is
always very difficult. When the suppression of Anopheline mosquitoes was
first recommended as a means of getting rid of malaria it was thought that
in nearly all malarious places the task would be comparatively easy and
inexpensive, and on this assumption many campaigns were begun. As the
campaigns proceeded it was found that little or no effect on the number of
Anophelines can be produced by small and comparatively inexpensive
measures such, for example, as can be accomplished by the unaided efforts
of what are called "mosquito brigades." When this was realized it became
obvious that the suppression of Anophelines is not a method of reducing
malaria which can be adopted everywhere, and that before deciding to adopt
it in a place we must ascertain whether, as Major Ross has said, " the game
is worth the candle." Unfortunately in the limits of this small book we
cannot discuss the factors by which we must be guided in coming to a