3o8 
The  following  table  shows  the  effect  of  7necha7tical  prophylaxis 
alone,  which  was  carried  out  along  the  Italian  railways  :  the  first 
column  showing  the  percentage  of  fever  attacks  among  people 
protected,  the  second  among  those  not  protected.  The  difference  is 
striking :  — 
Mechanical  Prophylaxis  along  the  Station  Railways 
Year 
Persons 
protected 
Percentage  attacked  with 
fever 
Percentage 
atta 
of  control 
:ked 
Recurrent 
Primary 
Min. 
Max. 
1899 
24 
20'0 
200 
96 
1900 
27 
5-5 
7-5 
77 
92 
1901 
S)T65 
3-3 
20*2 
20 
96 
igo2 
5,851 
10*1 
2*0 
12 
81 
1903 
8,230 
22-5 
4-6 
10 
32 
1904 
00 
8-7 
2-0 
10 
27 
But  clearly,  mechanical  prophylaxis  was  applicable  only  to  a 
limited  number  on  account  of  the  expense,  and  hence  it  was  found 
that  in  Italy  the  method  which  was  capable  of  most  general  applica¬ 
tion  and  most  efficient  was  the  distribtiiioTt  of  quhtme,  and  here  it  is 
undertaken  entirely  by  the  State,  distributed  gratuitously  to  those 
who  are  too  poor  to  pay  for  it,  and  sold  at  cost  price  to  those  in  a 
better  social  position. 
The  following  diagram  shows  the  mortality  from  malaria  in  Italy 
before  and  after  the  commencement  of  State  distribution  of  quinine. 
It  will  be  observed  that  the  mortality  from  malaria  is  subject  to 
periodical  oscillations,  with  a  maximum  every  five  or  six  years,  but 
that  on  only  one  occasion,  from  1887  to  1902  (the  year  when  quinine 
distribution  was  begun),  in  Latium  and  South  Italy  alone  did  the 
mortality  sink  below  5)000)  while  in  two  years  it  was  over  10,000. 
After  1902,  however,  it  never  rose  as  high  as  5,000,  and  in  1906  was 
under  2,500,  an  enormous  annual  saving  of  human  life,  and,  further, 
the  periodic  rise  which  was  due  in  1905  or  1906  did  not  occur. 
