Proceedings of Sixth Annual Meeting 87 



but a real contribution to arouse the interest of the people to the 

 new menace. 



Let me draw you a contrast. I was last year in California, 

 where I made a malaria investigation through the Sacramento 

 Valley, a valley about one hundred and eighty miles long, I think. 

 It is without question one of the most fertile regions of the globe. 

 It is even more the land of promise than the Garden of Eden. It 

 is one of the most wonderful areas in every way that we have in 

 this whole country. The rainfall is unevenly distributed, so that 

 irrigation is necessary, and as the vast ranges are being broken up, 

 irrigation is becoming common. With irrigation has come malaria, 

 because the Anopheles mosquito is everywhere. Last year they had 

 some 15,000 cases of malaria, and possibly nearer 20,000. There 

 was not the slightest real public interest worthy of the name. Doc- 

 tor after doctor told us he was not reporting his cases. No at- 

 tention was being given to it locally in an effective manner. In 

 that great state, they have the finest rules and regulations for 

 malaria eradication that I know of anywhere, and yet they permit 

 the state to become infested with this disease, to develop new 

 endemic centers that may be extremely difficult tO' eradicate be- 

 cause of apathy. There you have the doctors in England, with 

 a few hundred cases and this report, and California, with several 

 thousand, and loss of life in every hour, indifferent. 



What has been done in malaria control work during the war 

 should not be lost. An enormous sum of money has been spent 

 in intra and extra-cantonment sanitation. It would be a crime if 

 those cantonments were surrendered or were permitted to fall 

 into disuse. And it is to be hoped that a plan which the American 

 Public Health Association has under consideration may prove 

 feasible: namely, that the cantonments shall be used for tjc^ vral 

 health purposes in some way; that they shall not fall into disuse. 

 We need them. We are at the beginning of a new health era, a real 

 health era. We are going to break in the next ten years with the 

 past in which the health officer was purely a delinquency officer, 

 purely a man ready to go on the job after the fact, after the disease 

 had broken out and attained to serious proportions, and then limit 

 his activities to prevent as well a new and further spread. I think 

 we are too deeply impressed with the failure of our health or- 

 ganizations, both in the recent influenza epidemic and in malaria, 



