130 MALARIA 



more skilful treatment this has been reduced to 7 per 

 thousand ; but the native, who is slow to change his 

 ways, and usually averse to modern methods of treat- 

 ment, still retains a very high fever death-rate — over 

 18 per thousand. During the years 1887- 1897 the 

 average mortality in Italy attributed to malaria was 

 1 5,000 a year, and 2,000,000 patients annually suffered 

 from ' fever.' 



Apart from the mortality due to this disease, the 

 amount of suffering and the decline in human power 

 and activity which it entails deserve careful attention. 

 Compared with the number of patients, the number of 

 deaths is by no means large. In round numbers, out 

 of every thousand soldiers in the British army in 

 India in 1897, 420 men were attacked by malaria, but 

 only one in a thousand died ; even in the ' most 

 malarious ' districts the death-rate only amounted to 

 6 per thousand. In Sierra Leone, a district much 

 more fatal than any in India, the average death-rate of 

 the white troops, based on hospital records extending 

 from 1892 to 1898, is estimated by Major L. M. Wilson 

 at 42-9 per thousand, whilst that of the coloured 

 troops is 5-9 per thousand. On the other hand, the 

 European troops show an annual number of cases of 

 2,134 per thousand, and the non- European troops 

 one of 1,056 per thousand. These figures probably 

 under -estimate the amount of fever amongst the 

 troops. It must be remembered that many soldiers 

 who have slight attacks of fever do not present them- 

 selves at the hospital, whilst of those who do a 

 considerable number are only detained for slight 

 treatment, and are never entered on the hospital 

 books, and so are not recorded on the returns. 



From the statistics quoted above, it appears that of 

 our soldiers in India three out of every seven suffer 

 from an annual attack of malaria sufficiently pro- 

 nounced to be recorded on the medical books, whilst 



