MAP-CHANGING MEDICINE 



319 



work to free itself from malaria. It suc- 

 ceeded so brilliantly that the disease was 

 entirely wiped out. 



Panama and a hundred other places 

 have been largely freed from malaria by 

 the application of the principles for its 

 control developed by Ross and his co- 

 workers. 



In Italy, under Celli, the war against it 

 brought down the number of deaths it 

 caused from 28,000 in 1888 to less than 

 2,000 in 19 10. In the district of Klang, 

 in the Federated Malay States, Watson 

 succeeded in reducing the number of hos- 

 pital cases of malaria occurring annually 

 from 334 in 1901 to 12 in 1906. In the 

 Dutch East Indies the Department of 

 Public Works at Sibolga succeeded, 

 through its anti-malaria campaign, in 

 driving down the annual mortality rate 

 from 79 out of every thousand people in 

 1912 to 18 in 1920. 



SIMPLE MEASURES REQUIRED 



But preventive measures that will com- 

 mend themselves to the communities that 

 need them most must be at once extremely 

 simple and very inexpensive — much more 

 so than those employed at Panama and 

 Suez. 



The sanitarians who are striving to re- 

 lease the peoples of the earth from the 

 merciless sway of malaria realize this, and 

 many of them have joined forces for the 

 formulation of a program for making any 

 community safe against malaria. This 

 has taken the form of large-scale, com- 

 munity-wide experiments in some of our 

 own Southern States. 



The anopheline mosquito is essentially 

 a rural resident, in contrast to the yellow- 

 fever carrier, which prefers an urban 

 situation. 



Therefore the malaria problem, in the 

 main, has become, under conditions of 

 modern sanitation, a matter to be dealt 

 with mainly by small towns, villages, and 

 country districts. 



With this in mind, a group of villages 

 and countrysides was selected where the 

 various methods of combating the mal- 

 ady would be tested, in some places em- 

 ploying one method, in others another, 

 and in still other communities a combina- 

 tion of two or three, or even of all known 

 methods. 



It was demonstrated in many town- 

 and villages in Arkansas and Mississippi 

 that from 75 to 95 per cent of the ma- 

 laria in a community can be eradicated at 

 an outlay of from 45 cents to $1.00 per 

 capita. So successful were these demon- 

 strations that in 1919 a conference com- 

 posed of the United States Public Health 

 authorities, members of State boards of 

 health, the directors of the International 

 Health Board, and local health officials 

 decided to make concerted demonstrations 

 in fifty-two towns in ten Southern States 

 in 1920. 



THE MOSQUITO BANISHED 



The results were astonishing. At an 

 average cost of 78 cents per capita, these 

 fifty-two communities, which had been 

 hot-beds of malarial infection, were 

 largely freed from the disease. 



Furthermore, by-products of the cam- 

 paign were community pride, popular 

 education in sanitation, and widespread 

 interest in health problems. 



The measures employed were: simple 

 drainage, filling pits and shallow pools, 

 channeling streams, clearing the margins 

 of streams and ponds, removing obstruc- 

 tions, turning in the sunlight, oiling, en- 

 listing the service of the top minnow, and 

 administering quinine. 



In Hinds County, Mississippi, in a 

 countryside campaign, oil and the top 

 minnow were used. They cut out yj per 

 cent of the cases of the disease at a per 

 capita cost of $2.60 in 1919 and $3.09 in 

 1920. 



The top minnow, Gambusia affinis, the 

 female of which is two-thirds as large as 

 a man's little finger, and the male half as 

 big, proved to be such a wonderful anni- 

 hilator of baby Anopheles that it is con- 

 sidered superior to oil in most cases. 



These minnows have voracious appe- 

 tites, and the baby mosquitoes are the 

 piece de resistance of their daily dinner. 

 In some waters they are able to eliminate 

 90 per cent of all the malarial mosquitoes 

 before these reach the flying age. 



There are some waters where oil can 

 be used to better advantage than top min- 

 nows, but in most cases the little fish are 

 masters of the situation. 



The fish are inefficient where the banks 

 of the pond or stream are overgrown with 

 vegetation. Here the pasturing of cattle 



