XXVlll 



ing disting-uished from the innocent culex 

 species. He illustrated the difference, 

 and said he had not come across a mem- 

 ber of the genus in Tasmania, and though 

 one S'pecies had recently been described 

 in Victoria he had not come across any 

 in that State, though he had made an, 

 examination of a large number. lUe 

 mosquito might be killed by fumigation 

 "with sulphur or pyrethum powder. That, 

 however, was an incomplete way, as since 

 the anopheles bred by preference in small 

 puddles and shallow stretches of weedy 

 swamp, or slowly moving water free from 

 small fish, its destruction was rather an 

 engineering than a medical question. 

 Much might be done by pouring kerosene 

 or paraffin on the surface in the propor- 

 tion of about a tablespoonlul to every 

 equare j^ard of surface, so as to form a 

 thin film, which clogged the air tubes of 

 the larvae and pupae, and also probably 

 killed the adult female while depositing 

 eggs. That remedy would be found effi- 

 cient by those who were worried bj^ the 

 local culices, which evinced a blood- 

 tBiirsty disposition, in New Town, at any 

 rate. Culex and anopheles larvae, which 

 •were known to every boy as the "wrig- 

 glers." were found in every tank and 

 pool in fairly warm weather. All species 

 of anopheles did not carry malaria. Cu_ 

 lices were especially fond of small collec- 

 tions of water, in pots and tanks — the 

 saucer of a flow-er-pot on a window-sill 

 might provide sufficient mosquitoes to 

 make the inmates" life a misery, while 

 an ordinary 400gal. tank would stock a 

 neighbourhood. The notoriously malari- 

 ous localities of Sierra Leone and Free- 

 town, formerly known as "the White 

 Man's grave," had. comparatively speak- 

 ing, been turned* into ftiealth resorts with- 

 in two years oS organised effort against 

 naosquitoe'S, and in Ismalia, a previously 

 notoriously malarial town, the average 

 number of cases had been reduced from 

 2,000 to 200 per annum b}^ one season's 

 work. Practically, there were no fresh 

 cases of malaria, once the work was got 

 going, and it was now possible to sleep 

 there in safety without a mosquito net, 

 probably for the first time in the history 

 of the town. To sum up the points, which 

 he briefly indicated, the following facts 

 had to be considered w&ierever malaria 

 had to be dealt with: — There was, firstly, 

 a blood parasite which was the cause of 

 the disease, and next came a particular 

 genus of mosquito, whose tissues afforded 

 the only place wherein this parasite could 

 complete its life cycle. Malaria could be 

 conveyed from man to man by injecting 

 blood in which the organism was, but 

 that need not be considered in practice. 

 Therefore, in tackling the question of 

 stamping out malaria thej^ naturally at- 

 tacked the mosquito. TKie adult insect 

 might be guarded against by mosquito cur- 

 tains, and other measures, to prevent its 



biting. The connection of yellow fever 

 with Havana was almost proverbial. The 

 average number of deaths from that dis- 

 ease alone was fully over 800 in each 

 year, and it had been estimated that some 

 6,000 persons died of that disease in 1897 

 and, in addition, the island of Cuba, and 

 adjoining parts of Brazil, acted as an 

 endemic focus whence, at various times, 

 the disease spread to many parts of the- 

 world, including Spain, Africa, and even 

 England. In Eio, from 1868 to 1900, over 

 40,000 people died of it. The SoutBiern. 

 States of America had also suffered dread- 

 ful visitations from it, so that we may 

 easily understand why "Yellow Jack" was- 

 a decaded name throughout South Amer- 

 ica, the West Indies, and the Southern. 

 United States. With the opening of the 

 Panama Canal, and the consequent short- 

 ening of the voyage from these localities 

 to Australia, and the Far East, it was 

 very probable that yellow fever would be 

 introduced to this side of tfhe world. 

 Three or four years ago sanitarians re- 

 garded this possibility with awe and fore- 

 boding; to-day they looked upon it, cer- 

 tainly, as a serious problem, but as one 

 which would give emphatically little 

 trouble, compared to the introduction oS 

 a few cases of small-pox. Eeferring to 

 sleeping sickness, Dr. Elkington «aid re- 

 searches made by Dr. Castellani and 

 others showed that the conveying agent 

 in that case was the tsetse fly, previously 

 well-known for tEie fatal effects of its bite 

 on horses and cattle, but only lately 

 known to be connected with disease in 

 human beings. The curative agent ap- 

 peared to be a form of organism known 

 as trypanosome, or, as it should be more 

 correctly termed, a herpetomonas. which 

 lived in the blood and fluids of the vic- 

 tim. Dr. Elkington next touched upon 

 the presence of plague in Australia, and 

 said there was a growing tendency on the 

 part of those who had to deal with the 

 disease to regard more and more suspici- 

 ously tfiie flea. A good deal of work had 

 been done on those insects of late years, 

 and more than 130 distinct species of fleas 

 had been classified, and new ones were 

 coming into knowledge month after 

 month. Plague was, certainly, a disease 

 of locality, and especially tended to in- 

 fect those who sleep in such a locality, 

 sparing those who move actively about 

 during their visits, and sleep or rest else- 

 where. It chose dark, squalid, vermin 

 haunted vicinities, and avoided to a great 

 extent any well-lighted places. Plague 

 did not. apparently, thrive in the soil, nor 

 was it known to enter the body with the 

 food, in human cases at least. In the 

 ordinary form — excluding pneumonio 

 plague — it entered by the skin, and in the 

 bubonic form, it certainl.v entered in the 

 lymphatic area, drained by the first af- 

 fected gland. Water played no part in 

 its dissemination. Eeferring to the house- 



