16 LOSS THROUGH INSIK "is THAT CABBY DISEASE. 
takes first in L901 and L902, and have been reported upon from time 
to time in the Journal of Tropical Medicine. The expenditure 
undertaken by the Government with a view to improving the health 
oi the inhabitants of these town- has been fully justified by the 
results, which promise to be of permanent value. The total expendi- 
ture for the town of Klang down to the end of 1905 was ^>.100 
($15,086), and the annual permanent expenditure i> about £60 ($292) 
for clearing earth drains and £210 (Sl.022) for town gardener-. For 
Port Swettenham the total expenditure to the end of 100.') was l'T.000 
($34,065), and the annual cost of keeping up the drain-, etc.. is ap- 
proximately £40 ($195) for clearing earth drain-, and £100 ($487) 
for town gardeners. 
The careful tabulation of cases and deaths and of the results of 
the examination of blood of children in especially drained area- 
indicates the following conclusions : (1) Measure- taken systematically 
to destroy breeding place- of mosquitoes in these town-, the inhabit- 
ants of which suffered terribly from malaria, were followed almost 
immediately by a general improvement in health and decrease in 
death rate. (2) That this was due directly to the work carried out 
and not to a general dying out of malaria in the district i- clearly 
shown b} 7 figures pointing out that while malaria has practically 
ceased to exist in the areas treated it has actually increased to a 
considerable extent in other parts of the district where antimalarial 
measures have not been undertaken. 
The statistics for 1905 are even more favorable than those for 1902, 
which gives a very strong evidence in favor of the permanent nature 
of the improvement carried out. In fact it seems as though malaria 
has been permanently stamped out at Klang and Port Swettenham 
by work undertaken in 1901, and this experience in the Malay States 
should be of value to those responsible for the health of communities 
similarly situated in many other parts of the world. 
Another striking example of excellent work of this kind is found 
in the recently published report on the suppression of malaria in 
Ismailia, issued under the auspices of the Compagnie Oniverselle du 
Canal Maritime de Suez. Ismailia is now a town of 8.000 inhabit- 
ants. It was founded b} T De Lesseps in April. 18G2. on the borders 
of Lake Timsah, which the Sue/. Canal crosses at mid-distance be- 
tween the Red Sea and the Mediterranean. Malarial fever made it- 
appearance in very severe form in September. 1>77. although the 
city had up to that time been very healthy, and increased so that 
since 1886 almost all of the inhabitants have suffered from the fever. 
In 1901 an attempt to control the disease was made on the mosquito 
basis, and this attempt rapidly and completely succeeded, and after 
two years of work' all trace- of malaria disappeared from the city. 
The work was directed not only against Anopheles mosquitoes, but 
