( .5;n 



IxMiiL!,' iiial.'iri.-i pnliciils, whom I iii\si'ir had Irciilcd wilh fnuii '1 h» 

 .') <j,raiiis |i(M" (lav and per «lose, and who had lilllc chance ol' hcin.i;- 

 cin'(Ml in Ii()nil)()l< ilscll'. 



Anionu' al Ihc Icasl "iOOO l)ajal< malaria palicnls, whom I li-cal('<l 

 specially in ( 'cnlial-liornco and of whom liai-(ll\ an\(lic(l. I ohscrxcMl 

 anolhci- Icllinu' dillcrcncc liciwccn llic rcaclioii of their l>o(l\ a^ainsl 

 the malaria-iidection and that ot" the lMii-o|»eaiis. 



W'iiereas nnd(M' nnlaxoni'ahle circnnistances man\' of the laltei- 

 perished niider raltid and sti'Oiiü;' syiii|)1oTns, sometimes so (pdcklw lliat 

 ('liiiiine was of no ;i\;iil, sncli aenlo cases with sti'oiii;- icterus, micon- 

 scionsncss and colla])se wci-e nevei- Ibnnd amoiii;' llie Dajaks. 1 saw, 

 however, maiiv cases where the disimse liad reaclKMJ an a<l\an('ed 

 slaii'e after protracted illness. 



Tliat this dillerence was not dne to lli(> iiderior stren,l>th of the 

 infection in Horiieo, \\ as proxcd l»v niv I'jiropean and iiati\e 

 fellow-tra\ellei-s, most of whom snlfered Uadiv from malaria ; to them 

 T had aiLiaiji lo administer from '2 lo .'> ui-ams of ninrias chim'iii a 

 day. and one of them 1 had to ,ui\'e a stronu' liypo<lermic injection 

 of I], '25 u'ram chinine within .'](> Iiom-s. 



Fi-oni all this w c may assume that the Dajaks hecome partially 

 immune if in youth they are subjected to repealed attacks of malai'ia. 

 Vet even then whatexei* weakens the conslilntion may uix'e rise lo 

 attacks of malai'ia, so that diseases of the respii-atory oruans or of 

 the di;Liestive orpins, wounds, diseases of infection and s|>ecially 

 exei-ythinii' that is c()m[)i-ised under the name of catcliinii," cold, <>'et 

 complicated wilh malaria. 



As the uioujitainous rt\uions on IIk^ rp|'*'''-'^I;diakam are among 

 lliose where malaria is of \-ery tVequent occiwi-eiice, it is clear, that 

 the P)ahan-|)()pula1ion snifer ui-eally from it and that the individual 

 experiences its eid'eehlinii,' inlluence fi-om early youth till death. 



Ueiiiu' used for years in my practice anioiiu- llieni to liud that 

 the great majoi'ity of cases \^ ere those of malai'ia, I was greatly 

 struck by the change after my arrival amonu' the Kenja population 

 of Apo Kajaii. I must add that my reputation as a physician 

 |)rocured me immediately after my arrival a great number of patients, 

 though only few had e\'er seen a Kuropeau on the coast before. 



It first struck me, that so many hydropic old people called in my 

 help, which had scarcely e\'er occurred in lower regions, \\ iKM'cas 

 the malaria-cases i-etii-ed to the backuroiuid and during my stay 

 contined themsel\-es to a few acute cases. 1 found then, that the 

 change in the sick-rate of the |)Opulation was chielly due lo the 

 prexalence of bronchitis with enijdiysenia and heart-disease, bronchitis; 



