Proceedings of Sixth Annual Meeting 89 



as has been shown in the army, by the very fact that they have 

 exterminated the mosquito so successfully, is due the fact that 

 they have not subsequently had to trouble much with malaria. 



The experience with malaria in Macedonia might have wrecked 

 the cause of the Allies if there had not been a turn in the tide 

 of war and if that section had been made the real center of the 

 contest. And it is without question the most difficult territory, 

 perhaps, in the world, in which successfully to fight malaria and 

 the mosquito. 



A very interesting little book has been written — one of a number 

 on Macedonia — that I cannot but recommend to all of you who 

 would like to know real facts. You can read it in half an hour, 

 but it brings home to you the truth that until they got away from 

 the idea that they could fight malaria in Macedonia by quinine 

 immunization, by daily dosing with quinine, and that they had to 

 concentrate their effort upon exterminating mosquitoes by any and 

 every means at their command, they could not make any headway 

 in reducing the none-effective rate to reasonable proportions. 



Captain LePrince and Dr. Gorgas went to Panama, I think, in 

 about 1906. At that time the Isthmus rate, the non-effective ad- 

 mission rate, was 514 per 1,000; or, in other words, broadly speak- 

 ing, one-half the labor force were continuously suffering from 

 malaria. In 1911 they had reduced that rate to 184, by 1915, to 

 51 ; by 1917, to only 14, or practically no cases of malaria now ex- 

 isted among the Isthmus labor force. 



At Crossett, Arkansas, during 1915, among a population of about 

 2,000 people, there were 2,500 calls for malaria among local physi- 

 cians. In 1916, when the first irrigation measures by the Rocke- 

 feller Commission were applied, that number was reduced to 741. 

 During 1917, it has been reduced to 200; during 1918, there were 

 only 25 cases left. 



At Hamburg, a nearby town, also about 2,000 people, in 1916, 

 they had 2,300 calls on local doctors for malaria; in 1917, only 

 260, when the work began; and in 1918, when it became really ef- 

 fective, there were only 59 cases. In other words, it practically 

 had disappeared. 



At Lake Village, an almost hopeless locality, typical of cypress 

 swamp regions, in a population of 2,000 people, there were 1,800 



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