28 
At five to eight years a greater percentage of children appear to 
show enlargement of the spleen and malarial parasites in their blood. 
Examination of 142 boys between the ages of ten and fifteen years, 
living in the suburbs, showed splenic enlargement 111 ^ 1 • ases, <>r 35'ijl 
per cent. 
Comparison of particular localities such as Mucb, the Bosque, 
S. Raymundo, Colonia Oliveira Machado, where the natives are of 
the very poorest class, shows a much greater percentage <»f children 
with malarial infection. In these places, quite 70 to go per cent uf 
the inmates of some of the huts are suffering from malaria. We hail 
many opportunities of observing such conditions during the course 
of our work in the swamps, and many times have found wh<>le families 
incapacitated. 
On the other hand, our observations show that children and 
adults living in the city, and well removed from malarial swamps, 
remain free from malaria. Such non-malarial districts are not hard 
to find in Manaos, and as the sanitation of the city improves, so will 
the number and extent of these localities increase. 
r he majority of the Americans, English, French and Germans 
live m the business section of the city and remain free from malaria. 
, 1Cn cases do occur > the infection can be quite easily traced. They 
have gone on a hunting or sailing expedition and exposed themselves 
to infection or are old • imported cases' fro m up-river or other parts 
of the tropics. Many Brazilian clerks are employed by these Anns, 
res-der!e ^ ' there 15 those who 
consterab e o C “ “l* 6 dty “ d adj3Cent to swamps. A 
the year ^ (ague) at some time during 
- D r;r, rsigst z ,rr - — 
m the swamps. “ 1 clt T to P ursu e our work 
tetanus fn chfC^oc^durtlg^ryeara f ”“ ti0n tr ° ubleS ' and 
ff 
As we show in th.. gdy ° f malari al origin. 
93 per cent, of the children ^ ° n ankylostomiasis - ** per cent, to 
Necator americanus, and practical ^ Suburbs are mfected with 
practically all our cases of malaria exhibited 
