MALARIA A CHECK ON PEOGEESS 



321 



country are not available. From a table comprising 22 cities it appears that two- 

 thirds of the deaths from malaria in the United States occur in the South — one- 

 third only in the North. The death rate from malaria by States is available only 

 for the following registration States : California, Colorado, Connecticut, District 

 of Columbia, Indiana, Maine, Maryland, Massachusetts, Michigan, New Hamp- 

 shire, New Jersey, New York, Pennsylvania, Rhode Island, South Dakota, and 

 Vermont, all of which are Northern States. For these States the census reports 

 from 1900 to 1907, inclusive, give the following death rates : 



Deaths Due to Malaria in the Registbation States. 



1900-1907. 



" Estimating, from the preceding table, the average annual death rate due to 

 malaria, at 4.8 per 100,000 population, and considering that the registration area 

 includes only 16 of the Northern States (assuming fairly, however, that the 

 death rate in the other Northern States is the same), it seems reasonably safe to 

 conclude that the death rate from malaria for the whole United States must 

 surely amount to 15 per 100,000. It is probably greater than this, since the 

 statistics from the South are city statistics, and malaria is really a country 

 disease. Thus it is undoubtedly safe to assume that the death rate for the whole 

 population of the United States is in the neighborhood of 15 per 100,000. This 

 would give an annual death rate from malaria of nearly 12,000 and a total num- 

 ber of deaths for the 8-year period 1900-1907 of approximately 96,000. 



" But with malaria perhaps as with no other disease does the death rate fail to 

 indicate the real loss from the economic point of view. A man may suffer from 

 malaria throughout the greater part of his life, and his productive capacity may 

 be reduced from 50 to 75 per cent, and yet ultimately he may die from some en- 

 tirely different immediate cause. In fact, the predisposition to death from other 

 causes brought about by malaria is so marked that if, in the collection of vital 

 statistics, it were possible to ascribe the real influence upon mortality that 

 malaria possesses, this disease would have a very high rank in mortality tables. 

 Writing of tropical countries. Sir Patrick Manson declares that malaria causes 

 more deaths, and more predisposition to death by inducing cachectic states pre- 

 disposing to other affections, than all the other parasites affecting mankind to- 

 gether. Moreover, it has been shown that the average life of the worker in 

 malarious places is shorter and the infant mortality higher than in healthy 

 places. 



" But, aside from this vitally important aspect of the subject, the effect of 

 malaria in lessening or destroying the productive capacity of the individual is 

 obviously of the utmost importance, and upon the population of a malarious 

 region is enormous, even under modern conditions and in the United States. 

 It has been suggested that the depopulation of the once thickly settled Roman 

 Campagna was due to the sudden introduction of malaria by the mercenaries of 

 Scylla and Marius. Celli, in 1900, states that owing to malaria about 5,000,000 

 acres of land in Italy remain — not uncultivated, but certainly very imperfectly 



