196 



[September, 190!) 



(2) That this was due directly to the 

 work carried out and not to a general 

 dying out of malaria in the district is 

 clearly shown by figures pointing out 

 that while malaria has practically ceased 

 to exist in the areas treated, it has 

 actually increased to a considerable 

 extent in other parts of the district 

 where anti-malarial measures have not 

 been undertaken." 



" Another striking example of excellent 

 work is found in the recently published 

 report on the suppression of malaria in 

 Ismailia, issued under the auspices of the 

 Compagnia Universelle du Canal Mari- 

 time de Suez. Ismailia is now a town ot 

 8,000 inhabitants. It was founded by De 

 Lesseps in April, 1862, on the borders of 

 Lake Timsah, which the Suez Canal 

 crosses at mid-distance between the Red 

 Sea and the Mediterranean. Malarial 

 Fever made its appearance in very 

 severe form in September, 1877, although 

 the city had up to that time been very 

 healthy, and increased, so that since 1886 

 almost all of the inhabitants have 

 suffered from the fever. In 1901 an 

 attempt to control the disease was made 

 on the mosquito basis, and this attempt 

 rapidly and completely succeeded, and 

 after two years of work all traces of 

 malaria disappeared from the city. The 

 work was directed not only against 

 Anopheles mosquitoes, but against other 

 Culicids, and comprised the drainage of 

 a large swamp and the other usual 

 measures. The initial expense amounted 

 to 50,000 francs, and the annual expenses 

 since have amounted to about 18,300 

 francs." 



"The results may be summarized 

 about as follows :— Since the beginning 

 of 1903 the ordinary mosquiotes have dis- 

 appeared from Ismailia. Since the au- 

 tumn of 1903 not a single larva of Ano- 

 pheles has been found in the protected 

 zone, which extends to the west for a 

 distance of 1,000 meters from the first 

 houses in the Arabian quarter and to 

 the east for a distance of 1,800 meters 

 from the first houses in the European 

 quarter. After 1902 malarial fever ob- 

 viously began to decrease, and since 1903 

 not a single new case of malaria has been 

 found in Ismailia," 



" A very efficient piece of anti-malarial 

 work was accomplished in Havana dur- 

 ing the American occupation of 1901 to 

 1902, incidental in a way to the work 

 against yellow fever. An Anopheles 

 brigade of workmen was organized 

 under the sanitary officer, Doctor Gorgas, 

 for work along the small streams, irri- 

 gated gardens, and similar places in the 

 suburbs, and numbered from 50 to 300 

 men. No extensive drainage, such as 

 would require engineering skill, was 



attempted, and the natural streams and 

 gutters were simply cleared of obstruc- 

 tions and grass, while superficial ditches 

 were made through the irrigated mea- 

 dows. Among the suburban truck gar- 

 dens Anopheles bred everywhere, in the 

 little puddles of water, cow tracks, horse 

 tracks, and similar depressions in grassy 

 ground. Little or no oil was used by 

 the Anopheles brigade, since it was 

 found in practice a simple matter to 

 drain these places. At the end of the 

 year it was very difficult to find water 

 containing mosquito larvse anywhere in 

 the suburbs, and the effect upon mala- 

 rial statistics was striking. In 1900, the 

 year before the beginning of the mos- 

 quito work, there were 325 deaths from 

 malaria ; in 1901, the first year of the 

 mosquito work, 171 deaths ; in 1902, the 

 second year of mosquito work, 77 deaths. 

 Since 1902 there has been a gradual 

 though slower deci follows : 1903, 



51 ; 1901, 44 ; 1905, 32 ; 1906, 26 ; 1907, 23. 



Yellow Fever. 



The theory that Yellow Fever was 

 conveyed by the mosquito Stegomyia 

 fasciata, was first proposed by Finlay, 

 of Havana, in 1881. But it was not until 

 ten years later that the truth of this 

 theory was finally demonstrated. 



"The importance of the discovery can- 

 not be over-estimated, and its first 

 demonstration was followed by anti- 

 mosquito measures in the city of Havana, 

 undertaken under the direction of Gor- 

 gas, with startling results." 



"Yellow fever had been endemic in 

 Havana for more than one hundred and 

 fifty years, and Havana was the princi- 

 pal source of infection for the rest of 

 Cuba. Other towns in Cuba could have 

 rid themselves of the disease if they had 

 not been constantly reinfected from 

 Havana. By ordinary sanitary measures 

 of cleanliness, improved drainage, and 

 similar means the death rate of the city 

 was reduced, from 1898 to 1900, from 100 

 per thousand to 22 per thousand ; but 

 these measures had no effect upon yellow 

 fever, this disease increasing as the 

 non-immune population following the 

 Spanish war increased, and in 1900 there 

 was a severe epidemic." 



Stegomyia calojyus (= fasciatus) was 

 established as the carrier of the fever 

 early in 1901, and then anti-mosquito mea- 

 sures were immediately begun. Against 

 adult mosquitoes no general measures 

 were attempted, although screening and 

 fumigation were carried out in quarters 

 occcupied by yellow fever patients or 

 that had been occupied by yellow fever- 

 patients. It was found that the Stego- 

 myia bred principally in the rain-water 



