A few good stiff doses, he said, when the attack is on; that generally settles them. If not, they can begin again. To take quinine as a prophylactic, he considered folly. It might grow into a habit; you never know. . . .
It is to be hoped that such types are extinct, out there. They are extinct hereabouts. None but an ignorant person would now traverse malarious tracts in summer without previous quininization; or, if infected, deal with the disease otherwise than by an amply protracted treatment of cure. Yet it is only quite lately that we have gained our knowledge of a proper use of the drug; and this accounts for the great mortality long after its specific effects had been recognized by the profession. It was given both inefficiently and insufficiently. It was sold at a prohibitive price. The country people were distrustful; so-and-so had taken it for three or four days; he had improved, yes; but the fever was on him once more. Why waste money on such experiments?
I remember accosting a lad, anemic, shivering with the tertian, and marked by that untimely senility which is the sign-manual of malaria. I suggested quinine.
“I don’t take doctors’ stuff,” he said. “Even if I wanted to, my father would not let me. And if he did, there’s no money to pay for it. And if there were, it would do no good. He’s tried it himself.”
“Well, but how are you feeling?”
“Oh, all right. There’s nothing much the matter with me. Just the bad air.”
Such types, too, are practically extinct nowadays; the people are being educated to recognize their peril and how to avoid it; they begin to follow Professor Celli’s advice in the matter of regarding quinine as their “daily bread.” For since the discovery of the anophelic origin of malaria many devices have been put into execution to combat the disease, not the least of them being a popularized teaching of its causes and consequences by means of pamphlets, lectures to school-children, and so forth.
Now, you may either fight the anopheles—the vehicle, or the disease itself. The first entails putting the country into such a state that the mosquito finds it unpleasant to live there, a labour of Hercules. Yet large sums are being expended in draining marshy tracts, regulating river-beds and afforesting bare spaces; and if you are interested in such works, you will do well to see what is going on at Metaponto at this moment. (A considerable portion of the Government grant for these purposes has lately been deflected for use in the Tripolitan war.) Exemplary fines are also imposed for illicit timber-cutting and grazing,—in those towns, at least, where the magistrate has sufficient sense to perceive the ulterior benefits to be derived from what certainly entails a good deal of temporary hardship on poor people. Certain economic changes are helping in this work; so the wealth imported from America helps to break up the big properties, those latifundia which, says an Italian authority, “are synonymous with malaria.” The ideal condition—the extirpation of anophelines—will never be attained; nor is it of vital importance that it should be.
Far more pressing is the protection of man against their attacks. Wonderful success has crowned the wire-netting of the windows—an outcome of the classical experiments of 1899, in the Roman Campagna.
But chiefest and most urgent of all is the cure of the infected population. In this direction, results astonishing—results well-nigh incredible—have attended the recently introduced governmental sale of quinine. In the year 1895 there were 16,464 deaths from malaria throughout Italy. By 1908 the number had sunk to 3463. Eloquent figures, that require no comment! And, despite the fact that the drug is now sold at a merely nominal rate or freely given away to the needy—nay, thrust down the very throats of the afflicted peasantry by devoted gentlemen who scour the plains with ambulances during the deadly season—despite this, the yearly profits from its sale are amounting to about three-quarters of a million francs.