Proceedings of Seventh Annual Meeting 115 



house canvass in the Anderson-Cotton irrigation district of Shasta 

 County, California, and as a result he was able to present definite 

 data showing that the cost of malaria in 1918 in that district was 

 $5.70 per family for medicines, $7.10 for medical service, $18.90 

 for labor loss, or a total of $31.70, not including many items as to 

 which information was not available. In some subsections of this 

 district, which I have had occasion to investigate personally and as 

 to the facts of which 1 speak from personal knowledge, the net loss 

 per family was as high as $75.10. No state has a more profound 

 interest in malaria eradication than California, but primarily, there 

 as elsewhere, it is first a question of mosquito extermination. Not 

 only are large sections hindered in development and growth by 

 malaria frequency, but as much, if not more so, by the mosquito 

 pest, which, in certain irrigation and rice-growing districts, makes 

 life almost unbearable. The problem is one of eternal and thorough- 

 ly well sustained vigilance, effort and expense. Neglect is nowhere 

 perhaps so surely followed by disastrous results as in apathy and 

 indifference to the fact of mosquito spread. The war experience in 

 a number of countries in which, on account of the heavy burdens 

 called for by the dreadful conflict, mosquito eradication efforts were 

 temporarily abandoned or curtailed, sustains the foregoing conclusion 

 by an appeal to the facts. In British Guiana, for illustration, the 

 death-rate from malaria in 1918 increased to 54 per 1,000 of popula- 

 tion, against a minmum rate of 30.8 reached in 1914. The Surgeon- 

 General, in his report for 1918, takes occasion to point out that : 



Over and over again the profession has pointed out not only the large yearly 

 toll of deaths malaria exacts, but the large amount of disabling sickness it is 

 directly responsible for, considerably impairing the value of the laborer and 

 leaving him an easy victim to other diseases. Not uncommonly still-births, 

 premature births, and the births of weakly infants are due to the same active 

 cause, and further adversely affect the vital statistics. There can be no im- 

 provement unless anti-malarial measures, well recognized and successful in 

 other countries, be carried out here with the hearty co-operation of all con- 

 cerned. 



In the Punjab of India the annual malaria death-rate increased 

 from 14.72 in 191 5 to 19.44 in 1916, and 26.42 per 1,000 in 1917. 

 It is pointed out in the annual report of the Malaria Bureau, by Col. 

 H. Hendley, Chief Malaria Medical Officer, that "the number of 

 deaths from 'fever' has progressively increased during the past four 

 years in certain districts coincidently with the introduction of canal 

 irrigation," but, he adds, 



