84 



for sanitary leadership, are not directly concerned with the most 

 serious problem of the rural districts. I have much personal 

 knowledge of this. 



Yet another reason is, we are so used to malaria. In some 

 sections people are expected to have chills ''off and on" for the 

 early years of life. It is looked upon as a matter of course. 

 After childhood an immunity is acquired and malaria is not 

 common, but the child has been handicapped during the time he 

 was growing and getting his education. 



One favorable thing is that the area of prevalence of malaria, 

 certainly the area in which it is severe, is lessening. In eastern 

 North Carolina there is not one-third of the malaria there was 

 in the '8o's, probably not one-fourth. I think the same is gen- 

 erally true, maybe not to the same degree, in all of the cotton 

 States. On the contrary, it has increased in some sections of 

 these and other States. 



The reasons for this decrease are plain. They are primarily 

 the rise in the price of cotton and the fall in the price of quinine. 

 The first led to the prosperity of the farmer, and all are farmers 

 here; better living conditions; more land cleaned and drained, 

 and better cleared and better drained. I count drainage, espe- 

 cially tile drainage, as the key to the rural malaria problem. The 

 action of the second is obvious. 



The lessening of malaria due to the prospertity of the farmers 

 reacts on itself. As they became healthier their energy increased 

 and they became more prosperous still. More land is put in 

 cultivation and drained. Cultivation is cleaner and drainage is 

 better. The house may be screened, etc., and malaria is thus 

 further reduced, and so on, forming an endless chain of improve- 

 ment in which health and prosperity are alternate links. This I 

 was happy to see in many places in the South and Sbuthwest, but 

 in North Carolina especially. 



I am not going into the conveyance of malaria by the mosqui- 

 toes, but as only a few of you are physicians I will lay down a 

 few postulates : 



1st. Malaria is caused by parasites in the blood of the man 

 suffering from it. Men with such parasites in their blood are 

 infected with malaria. 



