80 



It is now proposed to isolate au fever patients in the malarial districts 

 and to protect the dwellings by screens — a tremendous undertaliing with 

 an area of 20,000 S(iuai-e miles and with a population, nnicli of it very 

 ignorant, of 2,500,000. 



CHANGES IN INDIANA. 



In regard to the changed condition in Indiana — the former prevalence 

 of malaria, especially in the Wabash bottoms, even only two or three 

 decades ago, and its comparative rarity at the present time: It seems 

 to me that the explanation is to be sought chiefly in tlie fact that proper 

 medication, the taking of sufficient quinine, is resorted to promptly now- 

 adays, resulting in the rapid disappearance of the disease, or disease 

 symptoms, in the afliicted individual, and tlius keeping the number of 

 foci from which the disease could be disseminated at a minimum, and at 

 the same time shortening the period of existence of such foci, or, in other 

 words: The fewer individuals there are in any neighborhood the less 

 the liability for the healthy to contract the disease. 



In former times quinine was a very costly remedy, used as a last 

 resort and usually in insufficient doses; to-day quinine is very cheap and 

 by many used for any suspicious malarial symptoms. 



Then, too, mosquitoes were, no doubt, more abundant in former times 

 than at present, owing to the greater number of wet places where the 

 animals could breed; stagnant water being one of the essentials in the 

 life history of the insect. Drainage is restricting such breeding places 

 more and more, thus indirectly reducing the number of mosquitoes. 

 Now that the proper relationship of malaria to swamps and pools is 

 known, it becomes a comparatively easy matter to still further diminish 

 the progeny of the "skeeters" still among us. The simplest method, 

 except drying up wet places, is to spread a film of oil over all bodies 

 of stagnant water— the larvae as they come to the surface to breathe 

 get the oil in the respiratory system and quickly perisli. The necessity of 

 isolating and properly protecting all malarial fever cases is self-evident. 



SUMMARY AND CONCLUSIONS. 



Malaria is a disease which once had a restricted distribution, but 

 which in the course of time has been distributed over the face of the 

 earth; it is most common in warm climes; it is due to a specific cause. 



