700 ANNUAL REl'ORT SMITHSONIAN INSTITUTION, 1908. 



examined, as otherwise the margin of error, as shown by Poisson's 

 formula, will be very considerable. For example, if 50 children be 

 examined and 25 of them be found to contain parasites the error will 

 be no less than 20 per cent; so that the approximate endemic index 

 will not be 50 per cent, as a hasty observer may think, but anything 

 between 30 per cent and 70 per cent. This fact is worth recalling, 

 because it has been much overlooked in recent work on the subject, 

 and because it shows how laborious the method really is. The second 

 method, that of examining children for enlargement of the spleen, a 

 thing which can be done in a minute, is much easier and fairly trust- 

 worthy, provided that no other cause for splenomegaly is present. 



With the valuable assistance of Doctor Kardamatis, general secre- 

 tary of the Grecian Antimalaria Society, and of Mr. D. Steele, 

 manager of the Lake Kopais Company, in Greece, I w^as able to use 

 both methods. The company's houses are on the southern border 

 of the plain, close to the site of the ancient Haliartos, where the 

 Spartan Lysander was defeated by the Thebans, 395 B. C, and to 

 the reputed grave of Alkmene, the mother of Hercules. The houses 

 are built just where the slopes of Helikon begin to rise from the 

 plain; so that they were obviously not too highly situated to be af- 

 fected by the malaria. On examining 57 of the employees, most of 

 whom were Greeks, we found an enlargement of the spleen in 14 and 

 the parasites in 9. But 5 of those that had parasites had no enlarge- 

 ment of the spleen, and must be added to the infected list, which 

 therefore amounts to 19 out of the 57, or one-third. The majority of 

 these people were adults, and many had come from other localities, 

 so that the figures are not useful for statistics. 



Our next care was to examine the people in some of the neighboring 

 villages. Out on the plain, about a mile or more from the company's 

 houses, there is the village of Moulki, containing some 350 inhabitants. 

 The houses are closely clustered together, with very irregular and ele- 

 mentary lanes between them. Going to the village inn close to the 

 school, we set to work and examined 80 persons, mostly children; 

 first by palpating them for enlargement of the spleen, and secondly, by 

 making dried films of their blood for future microscopical inquiry. 

 The scene was most interesting. Seated under a large tree, with the 

 village priest as our patron and protector, we pricked and palpated 

 the little ones, one by one. I never saw pluckier children. Scarcely 

 one of them even winced at the vivisection. Nearly all of them were 

 very intelligent, and many good looking; but, alas ! most of them w^ere 

 far from well, and some looked miserably ill, emaciated and anaemic. 

 The cause was speedily revealed. Out of 62 of the children be- 

 tween the ages of 5 months and 14 years, no less than 35 were 

 found to have enlarged spleens; and as no other cause of endemic 

 splenomegaly, such as kala-azar, could be ascertained to be i:>resent in 



