528 
Only 146 children are considered in the above table because only in 
that number could the age be ascertained. 
Family infections—The malarial infections are strictly local, being 
confined within certain well-defined limits, even in infected localities. 
Thus Celli, in Italy, observed that the families living upon one side of 
a canal in a certain town suffered greatly from malaria, while those 
residing upon the other were practically free. This was very noticeable 
in the barrios about Stotsenberg, certain places in the barrios being badly 
infected while others were almost unattacked. Not only was this true, 
but it was observed that malarial disease was very largely a family one, 
certain families suffering severely while others were free. The following 
table illustrates the family character of malarial infection, being compiled 
from the data obtained in one barrio in which the families resided : 
a . —_ 
Number Number 
Family. | of mem-| ofinfec- Variety. 
bers. tions. 
1 4 2 | 1, estivo-autumnal; 1, tertian. 
2 3 2 | 2, estivo-autumnal. 
3 4 2) 1, estivo-autumnal; 1, tertian. 
4 5 4 | 2, estivo-autumnal; 1, quartan; 1, tertian. 
5 4 2 | 2, eestivo-autumnal. 
6 3 2 | 2, estivo-autumnal. 
7 4 3 1, estivo-autumnal; 1, tertian. 
8 3 2 | 1, estivo-autumnal; 1, quartan, 
9 3 2 | 2, tertian. 
10 6 4 | 2, estivo-autumnal; 2, tertian. 
In considering this table, it should be remembered that these infections 
are latent in character and I have repeatedly observed families in which 
every member was suffering from a malarial attack, some presenting the 
symptoms of the disease while in others the condition was latent. Such 
are Nos. 4 and 10 in the above table. Family No. 4 is of great interest 
because, of its 5 members, 1 was suffering from a severe attack of tertian 
malaria at the time I made the blood examinations, while of the other 4, 
2 presented xstivo-autumnal, 1 the quartan, and the other the tertian 
plasmodium in the blood, so that in this one family all the varieties 
could be studied. From the data which has been given I believe it to 
be obvious that a large amount of the malaria at Camp Stotsenberg is 
directly due to the infection of the native, and there is no reason to 
doubt but that the same is true of every malarial locality in the Phil- 
ippine Islands. The natives are the culture tubes holding the plasmodia, 
the mosquitoes the inoculating needles, and the “stranger within the 
gates” the victim of inoculation. It is also apparent that it is useless to 
expect to rid a locality, from which the mosquitoes can not be eliminated, 
of malaria, unless the infection is first stopped among the natives, and 
in the Tropics, where it is practically impossible to destroy all mosquitoes, 
