1909.] on the Campaign against Malaria. 609 



of Celli and the Italian Anti-malaria Society, commenced early in 

 1899, has been based on the same, but also on a wider principle of 

 distribution of quinine, together with mechanical protection from 

 mosquito bites. "Working onward step by step against political 

 and local indifference, they have gradually made, during the last ten 

 years, a great reduction in the amount of the disease throughout 

 Italy. An independent witness, Professor Osier, has recently written 

 as follows to the Times : " In Professor Celli's lecture-room hangs the 

 mortality chart of Italy for the past twenty years. In 1887 malaria 

 ranked with tuberculosis, pneumonia, and the intestinal disorders of 

 children as one of the great infections, kilhng in that year 21,033 

 persons. The chart shows a gradual reduction in the death-rate, 

 and in 1906 only 4871 persons died of the disease, and in 19 07, 4160." 

 I should be unable to hang a similar chart for British possessions in 

 my lecture room. 



In 1900-01, a great discovery, closely connected with our subject, 

 was made by the Americans in Havana — I mean the discovery that 

 yeUow fever, the scourge of tropical America, is also carried by 

 mosquitoes of the kind called Stegomyia. With the Americans, 

 however, there was no delay in turning this fact to practical account, 

 and under General Wood and Colonel Clorgas they got rid of the 

 disease from that large city in a few months. Since then. Colonel 

 Gorgas has been conducting the magnificent sanitary work of the 

 Americans in the Panama canal zone — work the success of which is 

 too well known to require illustration by figures, but which has 

 enabled the Americans to do what the French, before the date of 

 these discoveries, failed in doing, namely to continue the construction 

 of the canal. It is not too much to say that the canal is being made 

 with the microscope. Colonel Gorgas has repeatedly stated that the 

 measure upon which he principally relies, against both yeUow fever 

 and malaria, is the general reduction of mosquitoes. 



For three years my original proposals to remove malaria by this 

 means had not been thoroughly and formally applied by any 

 government ; but I have now to record the first classical successes 

 obtained by it in Ismailia and in the Federated Malay States. The 

 former is a town founded by Ferdinand de Lesseps on the Suez 

 Canal. For many years it has suffered extremely from malaria, the 

 cases amounting ultimately to about 2000 a year among a small 

 population. In 1902 I was asked by Prince Auguste d'Arenberg 

 to advise on the matter ; and my advice was acted upon loyally and 

 intelligently by his officers in the town. The result was that the 

 cases fell to 214 next year, and to 90 in 1904, and that since then 

 there has been no endemic malaria in the town at all, while mosquitoes 

 of all kinds have been practically banished from it. The work in 

 the two small towns of Klang and Port Swettenham in the Federated 

 Malay States was begun about the same time, chiefly by Dr. Malcolm 

 Watson, under the orders of the Government, and of Dr. E. A. 0. 



