MALARIAL PROPHYLAXIS- SEGREGATION 
225 
we believe but lew men would employ them with sufficient care to avoid infection in 
such places Similarly with regard to houses protected with wire gauze. Even where 
the oppressiveness of the climate would not preclude their use, we consider that it is 
only by a constant vigilance that but tew men would exercise that such measures 
could be successful. 
As a preliminary step to all other prophylactic measures, and as one likely 
more than any other to minimize European malaria we, therefore, advocate ' Segre- 
gation from the Native.' 
Since we first put forward segregation as a principle to be followed whenever 
opportunity offered, it has been recognized by some authorities* as the first law of 
hygiene in the tropics ; on the other hand it has met with criticism. Much of the 
latter is evidently based on mistaken notions of what is meant by segregation, and 
what segregation entails. Segregation as an anti-malarial measure does not, for 
instance, mean the avoidance of intercourse with the native. Nor does it mean a 
lessening of the power of control of the native. It has been said that segregation 
means giving up a country. Such a notion could only arise from a complete mis- 
conception of what is meant by segregation in this connexion. The fact that in India 
segregation is almost universal seems to us to effectively meet such objections. In 
India we do not, except rarely, find European dwellings and native quarters crowded 
together, but almost always a well-designed European quarter, quite distinct from the 
native bazaar, l et in India there can be no question of loss of touch with the 
natives — rather on the contrary, an increased respect on their part. 
To talk also of the impossibility or impracticability of segregation in Africa is 
absurd, because a most excellently carried out scheme of segregation already exists at 
Accra (Victoriaborg), and to a less extent at Old Calabar, which places are noted on 
the West Coast for their comparative healthiness. Moreover, since we first advocated 
such measures they have been advocated also by ANNETTand Dutton (Second Liver- 
pool Expedition) as applicable, above any others, to Nigeria. These authors had 
actual experience, during many months, of the condition under which the European 
lives, and they advocate segregation as strongly as we do ourselves. 
Further, Logan Taylor, himself engaged in destructive measures against 
mosquitoes, says,f 'When suitable ground can be had I think it better for the 
European to live away from the native town. In Accra the Government officials 
have good bungalows away from the native town, forming a proper European quarter 
(Victoriaborg), and this arrangement is found to work well, and Accra is the healthiest 
town on the Gold Coast.' £ 
* Manson. Practitioner, iopo. Annett and Dutton, Second Expedition Liverpool School. 
-f- Second Progress Report of the Campaign against Mosquitoes in Sierra Leone. Liverpool University Press. 
I That segregation is a practical measure there is increasing evidence to shew. Thus at Akassa (Nigeria) ' a hotbed of 
fever and disease,' segregation has been effected (together with drainage and the regular administration of quinine to Europeans), 
and Akassa is now one of the healthiest stations in West Africa. (Brit. Med. Journ., April lS, 1903, p. 924.) Further segre- 
gation schemes have been carried out at Secondee and Cape Coast Castle. 
E I 
