502 
■rice  pieces,'  gave  ;5  per  cent.,  while  another  tinder  different 
conditions  showed  no  enlarged  spleens. 
In  Kingston,  among  the  220  children  whom  I  was  able  to  examine, 
there  was  only  a  percentage  of  10-4.  A  complete  splenic  census  of  the 
towns  would,  however,  show  considerable  variations. 
It  is  evident,  then,  that  in  this  method  we  have  one  of  considerable 
value  m  determining  the  distribution  and  prevalence  of  malaria  ;  and 
1  would  suggest  the  advisability  of  undertaking  a  more  comprehensive 
splenic  census,  by  having  all  the  schools  of  the  Colony  systematically 
examined.  The  examination  is  a  very  simple  one,  and  will  require 
only  a  few  seconds  for  each  child.  Two  points  only  need  be  noted: 
the  presence  of  enlarged  spleen  and  the  size.  The  age,  sex,  and  race 
of  child  can  be  supplied  by  the  teacher.  The  importance  of  this 
information  will  be  evident  when  I  discuss  one  of  the  methods  of 
prophylaxis. 
1  should  like  to  mention  a  point  here  which  struck  me  very  much 
in  examining  the  schools,  and  that  is,  that  the  school  registers  in 
most  cases  showed  the  most  marked  variations  in  attendance,  the 
number  of  absentees  rising  enormously  at  certain  periods.  This  must 
inevitably  interfere  very  much  with  educational  progress,  and  tend  to 
lower  the  standard,  and  as  a  considerable  proportion  of  these  absences 
are  undoubtedly  due  to  malaria,  any  diminution  in  that  disease  among 
the  children  which  would  promote  more  regular  attendance  would 
indirectly  foster  the  cause  of  education. 
SUMMARY 
1  may  now  summarise  the  facts  which  we  have  ascertained 
regarding  the  prevalence  of  malaria  :  — 
1.  The  total  malarial  deaths  for  the  whole  Island  during  ten 
years  amounts  to  34,695. 
2.  This  is  equivalent  to  an  average  annual  death-rate  of  44 
per  thousand. 
3.  The  average  percentage  of  malarial  deaths  to  total  deaths  is 
197,  representing  nearly  one-fifth  of  the  total  deaths. 
4.  The  total  admissions  to  hospitals  from  all  causes  has  risen 
from  16,103  to  21,837  in  four  years,  an  increase  of  26  per  cent. 
