PROPHYLAXIS 



1203 



4. Air-temperatures suitable for the development of the 



malarial parasite in man and anophelines. 



5. Free access of infected anophelines to non-immune human 



beings. 



To summarize, there are three factors: (i) Man; (2) the anophe- 

 line; (3) the air-temperature. 



In the tropics this third factor is in favour of malaria, and it 

 cannot be altered; therefore methods of prophylaxis must be 

 devoted to the human being and the anopheline. 



Man. — ^The preliminary step with regard to man is to ask his 

 intelligent assistance, and for this purpose education with regard 

 to disease in general and malaria in particular is required. First 

 of all it was necessary to bring the medical profession into touch 

 with the discoveries made by Laveran, Manson, Ross, and Grassi, 

 and this has been done. Secondly, it was and is necessary, by 

 lantern lectures, illustrated pamphlets, etc., to convince the edu- 

 cated public of the tropics of the monetary loss caused to the 

 Government, the planter, the merchant — i.e., to the employer of 

 labour — ^by malaria. Unless this can be done, the money necessary 

 for the effective prophylaxis will not be forthcoming. No one will 

 deny that malaria is the greatest cause of sickness in the tropics, 

 though there may be places where its mortality is low and places 

 where it is high, but that which people fail to recognize is the 

 financial loss caused by this sickness. 



Therefore we quote the well-known example of the Adriatic 

 Railway Company, which, according to Ricchi, used to spend on 

 account of malaria among 6,416 workmen living in malarious areas 

 no less than 1,050,000 francs per annum. 



But a serious attempt should be made to impress the uneducated 

 masses of the tropics with some sort of knowledge about the disease. 

 This can best be done by simple kindergarten-like instruction, with 

 demonstration of actual living specimens of anopheles and their 

 eggs, larvae, and pupae, together with the presence of a young child 

 with a huge spleen and of a person suffering from malarial cachexia, 

 and then, at the close of the lecture, to distribute illustrative 

 pamphlets in the vernacular, written in simple language, reviewing 

 the subject of the lecture, together with, if possible, the demonstra- 

 tion of the larvae in a neighbouring stream or pool. 



This attempt to instruct the poorer classes of the tropics may not 

 be productive of much immediate good, but it may bring home to 

 them that malaria is a potent factor in causing illness and death 

 among their infants and young children, and that it is caused by 

 the bite of a particular kind of insect, and can be to a great extent 

 prevented by proper treatment with quinine. 



Another method employed is to give the teachers of the elemen- 

 tary vernacular schools a course of instruction in elementary hygiene, 

 including, of course, malaria, so that they may be able to give their 

 pupils elementary instruction in these matters. 



