499 
immunity  from  malaria.  For  our  purpose,  therefore,  it  is  onl\' 
necessary  to  examine  children  under  that  age,  and  this  method 
undoubtedly  affords  a  very  valuable  index  for  comparative  purposes 
of  the  prevalence  of  malaria  in  different  localities. 
Following  the  lines  laid  down  by  Professor  Ross,  I  endeavoured 
to  carry  out  a  splenic  census  as  extensively  as  possible  in  different 
parts  of  the  Island.  Unfortunately,  at  the  time  of  my  visit,  the 
schools,  which  afford  the  best  means  of  examining  a  large  number  of 
children,  were  closed  for  a  month  owing  to  the  Christmas  holidays, 
and  I  found  it  very  difficult  to  get  together  a  considerable  number. 
However,  with  the  kind  assistance  of  the  District  Medical  Officers, 
and  of  the  Clergy,  I  was  able  to  examine  personally  2,036  children, 
and  the  interesting  results  are  shown  in  Table  X.  In  addition  to 
obtaining  the  total  number  with  enlarged  spleens,  I  was  at  some 
trouble  to  obtain  exactly  the  degree  of  enlargement  and  have,  as 
suggested  by  Professor  Ross,  divided  the  spleens  into  four  groups  : 
normal  spleens,  and  those  showing  three,  six  and  nine  inches  degree 
of  enlargement  respectively.  This  gives  what  Ross  calls  the  Average 
Spleen,  and,  as  he  points  out,  is  more  likely  to  give  a  more  delicate 
index  of  the  amount  of  malaria  in  a  given  locality  than  the  simple 
spleen  rate. 
I  am  unable  to  obtain  from  the  Registrar-General’s  returns  any 
idea  of  the  total  number  of  children  in  the  Island  up  to  the  age  of  16, 
but  in  any  case,  with  such  a  small  proportion  as  2,036  it  is  manifest 
that  it  is  impossible  to  draw  any  sweeping  generalisation,  nor  is  it 
possible  to  make  any  comparison  with  the  parochial  death-rate, 
because  the  latter  is  calculated  for  the  whole  parish,  while  my 
observations  were  confined  to  small  areas.  But  the  Table  is  of  very 
considerable  value  in  this  respect,  that  it  enables  us  to  place  our 
finger  with  absolute  certainty  on  certain  spots  where  the  endemic 
index  is  very  high,  and  it  enables  us  with  equal  certainty  to  exclude 
certain  localities  from  the  malarial  area,  and  is  of  importance  as 
indicating  the  localities  to  which  anti-malarial  measures  should  be 
applied  without  delay,  and  as  excluding  others  where  the  urgency  is 
not  so  extreme. 
The  following  table  gives  the  results  in  the  different  parishes.  Of 
the  children'  examined,  over  a  fourth  showed  enlargement  of  the 
spleen. 
