654 MALARIA. 



That malarial fevers may be transmitted by mosquitoes of the genus 

 Anophdeti was first demonstrated by the Italian physician Bio-nami, 

 whose experiments were made in the Santo Spirito Hospital in Rome. 

 The subjects of the experiment, with their full consent, were placed in 

 a suitalile room and exposed to the bites of mosquitoes brought from 

 Maccai-ese, "a marsh}' place with an evil but deserved reputation for 

 the intensity of its fevers." It has been objected to these experiments 

 that they were madc^ in Rome, at a season of the year wh(Mi malarial 

 fevers prevail to a greater or less extent in that city, but Marchiafava 

 and Bignami say: 



It is well known to all physicians here that, although there are some centers of 

 malaria in certain portions of the suburbs, the city proper is entirely free from 

 malaria, a>* long experience has demonstrated, and at no season of the year does one 

 accjuire the disease in Home. 



In view of the objection made, a crucial experiment has recently 

 been made in the city of London, The result is reported b}- Manson, 

 as follows: 



Mosquitoes infected with the parasite of benign tertian malarial fever were sent 

 from Rome to England, and were allowed to feed upon the blood of a j)erfectly 

 healtliy individual (Dr. Sanson's son, who had never bad malarial disease). Forty 

 moscjuitoes in all were allowed to bite him between August US) and Sei)tend)er 12. 

 On 8ej)tend)er 14 he luul a rise of temperature, with headache and slight cliilliness, 

 but no organisms were found in his bltxul. A febrile paroxysm (jccurred daily 

 thereafter, but the parasites did not appear in the blood until September 17, when 

 large numbers of typical tertian ])arasites were found. They soon disa])peare<l under 

 the influence of quinine.' 



We have still to consider the question of the transmission of malarial 

 fevers by the ingestion of water from malarious localities. Numerous 

 medical authors have recorded facts which they deemed convincing as 

 showing that malarial fevers ma}^ be contracted in this way. I have 

 long been of the opinion that while the o})served facts may, for the most 

 part, be authentic, the inference is based upon a mistake in diagnosis; 

 that, in truth, the fevers which can justly be ascribed to the ingestion of 

 a contaminated water supply are not true malarial fevers — i. e., they are 

 not due to the presence of the malarial parasite in the blood. This view 

 was sustained by me in my work on "Malaria and Malarial Diseases," 

 pu])lished in 1883. The fevers supposed to have been contracted in 

 this waj' are, as a rule, continued or remittent in character, and they 

 are known under a variety of names. Thus we have ""Roman fever," 

 "Naples fever," '"remittent fever," "mountain fever," "typho-mala- 

 rial fever," etc. The leading physicians and pathologists, in regions 

 where these fevers prevail, are now convinced that they are not mala- 

 rial fevers, but are simply more or less typical varieties of tjqihoid 

 fever — a disease due to a specific bacillus and which is commonly con- 

 tracted as a result of the ingestion of contaminated water or food. 



^ Quoted from an editorial in the New York Medical Journal of October 20, 1900 



