252 



ROME ASPECTS OP TKOriCAT, SANITATION 



The 

 Inspector's 



Malaria 



A story with 

 a moral 



bribery and corruption so prevalent throughout tlic Kiist must also not be forgotten in 

 the list of foes. 



Last anionfjst the Inspci-tor's friends I hope I may place the Medical Officer of 

 Ilealtli. He must train and aid the Inspector. He must look well after liis interests, 

 lie must not press him too liard, and he must seek to reward good and faithful service. 

 He must also be prepared to back him to the uttermost, so long as he is confident that 

 the Inspector is in the right and is acting with due courtesy in any contest which may 

 arise. 



As regards enemies, besides those already noted, we may mention the prevalence of 

 insect life, but this leads us to speak at once of the communicable diseases, which it is 

 the Inspector's main duty to prevent, to keep in check, and to abolish. 



First and foremost stands malaria. An Inspector has scarcely settled down before 

 he is haled to the Wellcome Tropical Research Laboratories and instructed in the 

 mysteries of mosquito life and propagation. The instructions need not be very extended 

 or very minute. Three species of mosquito alone concern hiin closely — the malaria- 

 carrying Pyretophorus costalis, the ubiquitous and well-haunting Oidex fatigans and tlie 

 dweller on board steamers and boats, the breeder in "zeers" and domestic utensils, the 

 black-and-white, vicious tiger mosquito, Stegomijia calopus or fasciata, which in the New 

 World has gained so unenviable a notoriety as the carrier of the virus of yellow fever. 

 The Inspector must speedily familiarise himself with the water stages of these three insects. 

 He must know, above all things, their respective larvie, and should be able at once to 

 "spot" their respective eggs and pupae. He must know their habits and their 

 distribution in the town. He must learn how to combat them, and he must never 

 weary in well-doing. 



We learn by our failures, and I can, perhaps, best illustrate this most important 

 work by a few tales regarding it. Those who desire further information regarding the 

 campaign in Kliartoum and its results may consult our laboratory Reports, and the 

 chapter in The Prevention of Malaria, by Professor Ronald Ross. 



As the Blue Nile falls, pools are left in its sandbanks, and in these pools 

 Anopheline larvaj speedily make their appearance, the mosquitoes invading the 

 precincts of the town from outside, or being conveyed into it by steamers or boats. 

 Now, just above the British Barracks, extensive sandbanks formed, pools were left, and 

 in these pools Anopheline larvae were found. The pools were treated, but whenever 

 fresh ones formed tliey became infected. It was evident that Pi/retophonin costalis was 

 in the neighbourhood, though not a single adult mosquito could be found. The British 

 soldiers were in the habit of wandering along the river bank near these pools. They 

 belonged to a regiment which had suffered from malaria elsewhere. The weather was cold. 

 What happened? An old case relapsed, and immediately several cases of primary 

 infection occurred, nine in all, I think, and, fortunately, not of a severe type. I could 

 not find out whence the Anophelines were coming. On the other side of tlie river 

 from these pools there existed an area of irrigated land, a thorn in the flesh, but it 

 was always closely watched, and I was assured by the man in charge that all was well 

 there. Such inspections as I made confirmed his statement. I was forced to believe 

 the mosquitoes were breeding out in pools higher up the river, which, owing to their 

 distance from the town, could not be controlled. Suddenly, however, the Sanitary 

 Inspector himself, who lived near the farm, fell ill. I found he had malaria of the 

 same type as that in the British soldiers. A very thorough search all over the irrigated 

 area was at once instituted, and Anopiielines were foun<l breeding in several channels 



