16 LOSS THROUGH INSECTS THAT CARRY DISEASE. 



taken first in 1901 and 1902, and have been reported upon from time 

 to time in the Journal of Tropical Medicine. The expenditure 

 undertaken by the Government with a vicAv to improving the health 

 of the inhabitants of these towns has been fully justified by the 

 results, which promise to be of permanent value. The total expendi- 

 ture for the town of Klang down to the end of 1905 was £3,100 

 ($15,086), and the annual permanent expenditure is about £60 ($292) 

 for clearing earth drains and £210 ($1,022) for town gardeners. For 

 Port Swettenham the total expenditure to the end of 1905 w^as £7,000 

 ($34,065), and the annual cost of keeping up the drains, etc., is ap- 

 proximately £40 ($195) for clearing earth drains, and £100 ($487) 

 for town gardeners. 



The careful tabulation of cases and deaths and of the results of 

 the examination of blood of children in especialW drained areas 

 indicates the following conclusions: (1) Measures taken systematically 

 to destroy breeding places of mosquitoes in these towns, the inhabit- 

 ants of which suffered terribly from malaria, were followed almost 

 immediately by a general improvement in health and decrease in 

 death rate. (2) That this w^as due directly to the work carried out 

 and not to a general dying out of malaria in the district is clearly 

 shoW'U by figures pointing out that while malaria has practically 

 ceased to exist in the areas treated it has actually increased to a 

 considerable extent in other parts of the district where antimalarial 

 measures have not been undertaken. 



The statistics for 1905 are even more favorable than those for 1902, 

 wdiich gives a very strong evidence in favor of the permanent nature 

 of the improvement carried out. In fact it seems as though malaria 

 has been permanently stamped out at Klang and Port Swettenham 

 by work undertaken in 1901, and this experience in the Malay States 

 should be of value to those responsible for the health of communities 

 similarly situated in many other parts of the world. 



Another striking example of excellent w^ork of this kind is found 

 in the recently published report on the suppression of malaria in 

 Ismailia, issued under the auspices of the Compagnie Universelle du 

 Canal Maritime de Suez. Ismailia is now a town of 8,000 inhabit- 

 ants. It was founded by De Lesseps in April, 1862, on the borders 

 of Lake Timsah, which the Suez Canal crosses at mid-distance be- 

 tween the Eed Sea and the Mediterranean. Malarial fever made its 

 appearance in very severe form in September, 1877, although the 

 city had up to that time been very healthy, and increased so that 

 ' since 1886 almost all of the inhabitants have suffered from the fever. 

 In 1901 an attempt to control the disease w^as made on the mosquito 

 basis, and this attempt rapidly and completely succeeded, and after 

 two years of work all traces of malaria disappeared from the city. 

 The work was directed not only against Anopheles mosquitoes, but 



