27 2 Proceedings of Royal Society of Edinburgh. [sess. 
there are small and isolated areas where malaria is endemic on 
the marshy banks of the rivers or lakes, e.g ., the valleys near the 
Neckar in the Black Forest. The more extensive malarial regions 
are on the banks of the Rhine, in lower Alsace, in the Palatinate, 
in the Rheingau, and in the low grounds of the Danube, and its 
side valleys in Wurtemburg and Bavaria. In central Germany it is 
only endemic in a few small districts. In North Germany it is 
found in the basins of the Vistula, Oder, Elbe, Weser, and Rhine. 
Holstein and Schleswig (west coast districts), the coast belt west 
of the Elbe, the moorlands of Hanover and Oldenburg, the low 
grounds of Westphalia, and the plains of Rhenish Prussia are also 
infected. In the Netherlands malaria is mostly found in the 
provinces of Gronland, Friesland, and Zealand, on the coast belt 
of the provinces of north and south Holland, and in the provinces 
of Drenthe Overyssel. Belgium, West Flanders, East Flanders, 
and Antwerp are affected. The disease also occurs in Laaland 
and Falster, on the Hvaloen islands, and in the neighbourhood 
of Fredericstadt. In Sweden it is endemic at three principal 
points — around Lakes Maler and Werner, on the east coast of 
Torhamn, and at the mouth of several coast streams, such as the 
Angermanna-elf, the Dal-elf, and Gotta-elf. In Britain, the East 
Riding of Yorkshire, the Fen district, Essex and Kent, the banks 
of the Thames in Surrey, and the south marsh of Somersetshire, are 
slightly infected by malaria. 
In the western hemisphere, endemic malarial fever of the 
severest type has its principal seats in the West Indies, on the 
Mexican Gulf coast, and in Brazil, but considerable regions of fever, 
though of a less intense kind, are met with in the northern parts of 
the Pacific coast of South America, and in the southern, central, 
and prairie States of the Union. All the West Indian Islands are 
affected, save Antigua, St Vincent, and Barbadoes, the Bahamas 
and the Bermuda group, in which islands it is rarely seen. 
In South America the worst centre of malaria is the east coast, 
including the ports of Carthagena, Maracaybo, and Puerto Cabello, 
and the country of Guiana. Another extensive area covers the 
whole of the north of Brazil as far as Rio de Janeiro, the banks of 
the Amazon, Rio Madeira, Maranhao, Paranahyba, San Francisco, 
Parana, Rio Doce, and their tributaries ; also the island of Santa 
