is
greatest during the time of birth of a new generation of young
parasites in the blood, which corresponds with the time of the
malarial attack. But in order that the quinine shall have time to
permeate the blood, it must be given two to four hours before the
expected chill, and then will probably prevent the next attack but
one. A dose of ten grains of quinine sulphate taken three times daily
for the first three days of treatment; then a dose of three grains,
three times daily for two weeks; and finally two grains, three times
daily for the rest of the month of treatment will, in many cases,
complete a cure. If the quinine cause much ringing in the ears and
deafness, it will be found that sodium bromide taken with the quinine
(in twice the dose) dissolved in water, will correct this trouble. If
the patient is constipated and the bowel discharges are light colored,
a few one-quarter grain doses of calomel may be taken every two hours,
and followed in twelve hours by a dose of Epsom salts, on the first
day of treatment, with quinine. It is no use to take quinine by the
mouth later than two hours before an attack, and if the patient cannot
secure treatment before this time, he should take a single dose of
twenty grains of quinine.

To children may be given a daily amount of quinine equal to one grain
for each year of their age. In the severe forms of remittent and
pernicious types of malaria it may be necessary for the patient to
take as much as thirty grains of quinine every three days or so to cut
short the attack. But, unfortunately, the digestion may be so poor
that absorption of the drug does not occur, and in such an event the
use of quinine in the form of the bisulphate in thirty-grain doses,
with five grains of tartaric acid, will in some cases prove effective.
Chronic malaria is best treated with small doses of quinine, together
with arsenic and iron. A capsule containing two grains of quinine
sulphate, one-thirtieth grain of arsenious acid, and two grains of
reduced iron should be taken three times daily for several weeks.

=YELLOW FEVER.=--This is a disease of tropical and subtropical
countries characterized by fever, jaundice, and vomiting (in severe
cases vomiting of blood), caused by a special germ or parasite which
is communicated to man solely through the agency of the bites of a
special mosquito, _Stegomyia fasciata_.

=Distribution.=--Yellow fever has always been present in Havana, Rio,
Vera Cruz