SUCCESS IN ITALY 441 
the mortality now runs from 0.050 to 0.800. In North Italy, in Piedmont and 
Liguria, malaria is now practically non-existent, and the same may be said for 
the province of Marche. In the Campagna itself, the mortality runs from 0.010 
to 0.050, or at least this was the condition in 1908, and affairs have improved 
since then. Again, it was Howard’s good fortune to visit the Campagna with 
Celli in May, 1910. The metamorphosis in the intervening eight years was 
simply miraculous. The Campagna has become populous; new buildings are 
going up on every hand ; the peasants are robust, well fed, and obviously healthy ; 
the children are fat, rosy, and full of life ; agriculture of the most intensive kind 
is going on everywhere; and capital has come down from North Italy and the 
price of land is rapidly increasing. Anopheles, however, is still breeding there, 
and can be seen in the irrigating and draining ditches. The whole country is 
reclaimed swamp, interspersed with small hills, with a tufa subsoil and volcanic 
tock beneath. Mechanical measures first undertaken to protect the buildings 
and huts with wire screens gradually reduced the percentage of infection with 
malaria from 65 per cent to 12 per cent. Beyond this point for a time it seemed 
impossible to reduce the disease, and then the quininization was begun. 
“ Government supplies of quinine were placed at points in the custom-houses 
where it could be readily had; poor people were given it for a time free; and 
it was made palatable for the children by giving pellets under proper dosage a 
heavy coating of chocolate, so that often babies cried for their medicine. Every 
possible means was used for advertising and for distributing. Conspicuous signs 
were posted along the roads and at the places of distribution. Small articles for 
sale in boxes contained the government directions concerning quinine, and even 
the covers of cheap cigarette packages were, and are, used for this purpose. 
“Tn fact, a degree of ingenuity has been shown in this advertising which is 
worthy of the most ingenious Yankee advertising agent. The cigarette package 
cover bears the following statements (literally translated) : 
“¢ OFFICIAL QUININE 
y a preventative and curative remedy of unquestionable efficacy against malarial 
ever. 
“¢ OFFICIAL QUININE is sold to the public at very moderate prices by phar- 
macists, drug-stores, and by private agencies that are licensed. 
“Tt is sold at a special rate 
by the 
‘Maggazino di deposito’ of Turin to charity organizations, to the city, to 
public and private persons who are obliged by law to furnish it gratuitously to 
the poor and laborers. 
“* Official quinine for gratuitous admimstration 
to the poor and laborers is prepared by the Central Military Pharmacy of Turin 
in tablets of 20 centigrams each, sugared in the form of candy. 
“* Official quinine for sale to the public 
is prepared by the Central Military Pharmacy of Turin in tablets of 20 centi- 
grams each, enclosed in small tubes of 2 grams each.’ 
“ Tt results from the universal use of quinine in the prescribed doses that the 
percentage of malaria has been reduced to less than 4 per cent, and this per- 
centage is maintained, although the mechanical protective means have been 
practically abandoned. The straw huts are no longer screened, and of the houses 
only the upper-story bedrooms. Door-screens have been abandoned. The whole 
country is full of life and energy, and the richness of the soil is so great that in 
a comparatively few years the Campagna will be supporting an enormous 
population. 
