TICE PREVENTION OF MALARIA.*
TRADE, they say, follows the flag; but disease goes with the flag, and comes back with the flag. Take, for example, the Crusades, or the discovery of the New World, or the opening up of Africa. If it be true, as it well may be, that the Crusaders brought back a certain disease into Europe, a scourge made of man's pleasant sins, here is a fact of more importance than the history of the Crusades. The discovery of the New World had for its immediate result the introduction of tuberculosis among the natives, killing vast legions of them, and not yet done with killing; and the making of routes and railways in Africa seems to be spreading the sleeping sickness almost into the Soudan. Where man goes he takes disease with him, or brings it back: and, with the advance of civilisation, man going everywhere, we are beginning to regard the world as a single case—a single patient suffering from a complication of dis- orders—and to think of the world's diseases not as local epidemics or endemics, but as forces or elements in the very constitution of the world.
Happily for mankind, our men of science have risen to the occasion. They have been able to learn the causes of things ; and, when the story of the past twenty years comes to be written, there will be a long chapter on the work of the bacteriologists and on the campaign against tropical diseases. Malaria, yellow fever, Malta fever, sleeping sickness are understood; they are fast losing their immemorial terrors. There has been no such series of discoveries, not since the world was first made, no such gifts toward the world's health. The quiet patience and endurance of the work, its delicate accuracy, its passionate interest, are above all praise and past all telling. It has received the one reward which alone was good enough for it, the reward of success.
If it were possible, we ought to be able to read in one book the whole amazing story of the fight against all tropical diseases: plague and cholera, malaria, yellow fever, and all the rest of them. For each discovery led to more discoveries; thus the Sleeping Sickness Commission, passing in 1908 through -Uganda, found on the shores of Lake Albert Edward, in the heart of Africa, a disease identical with Malta fever. Again, the story of the making of the Panama Canal, and of the work of Walter Reed, Lazear, and Gorges, is concerned not with yellow fever alone, but also with dysentery and malaria. But who is poet enough to write the whole story as it ought to be written ? Meanwhile, we have Major Ronald Ross's admirable book, The Prevention of Malaria, a fine, complete, and most inspiriting record of some of the best work that has ever been done for humanity.
Major Ross begins with a brief note on the references in the classics to malaria, some of them strangely prophetic ; , and he rightly praises Mr. W. H. S. Jones's valuable study of the influence of malaria over the fortunes of ancient Greece. The date of the birth of our present knowledge of malaria is November 6th, 1880, when Laveran saw under the microscope the living parasite of the disease in full activity. Finlay, Manson, Ross, MacCallum, Metchnikoff, and a host of other observers in all parts of the civilised world, studied the parasite, and formulated the mosquito theory. In August, 1897, Ross discovered the intermediate stage of " bird-malaria " in the stomach of the anopheles mosquito. In 1899 the newly formed Liverpool School of Tropical Medicine sent out its first expedition, the first of many happy argosies of science; and in November of that year Koch, in Java, discovered that not the native adults but the native children are the chief source of infection. In 1900 Sambon and Low and Terzi set up their famous mosquito-proof hut near Ostia, in a district saturated end rotted with malaria, and lived in the hut all through the malarial season, without a grain of quinine, and without a touch of malaria. In 1900, also, P. T. Manson and G. Warren, at the London School of Tropical Medicine, made their famous experiment, letting themselves be bitten by infected mosquitoes sent from Rome, and in due time were seized with malaria. Thus in three years, between 1897 and 1900, the thing was done, was proved beyond all possibility of doubt: Anopheles maculipennis, the dapple-winged mosquito, voila. rennemi. And all the age-long talk about miasmata and exhalations was put away, for ever and ever, in the grave of dead theories.
- • The Prevention-of Malaria. By Ronald Ross, D.Sc., LL.D., _ F.R.S., Nobel aureate. With Contributions by Other Writers. Many Illustrations. London : John Murray. pls. net.a
It is only ten years from these experiments until now. The proof that malaria is conveyed from man to man by mosquitoes was a sure guide to the prevention of malaria. The haunts and habits of anopheles were carefully studied, and the work was put in hand to reduce the number of its breeding-places, and to break the round of its life. It lays its eggs on any little surface of still water,—small pools and puddles, ditches, water-butts and cisterns, rain-water caught in pots and pans, empty tins, broken crockery, and all the odd rubbish of the backyard. Therefore the surface soil must be tidied up, the pools and ditches kerosened to kill the larvae, or stocked with minnows, or filled up with turf, or set running ; and all the debris must be cleared away round native huts and white men's quarters ; and cisterns and wells and water-butts must be kept covered. To reduce mosquitoes is to reduce malaria, and to keep off mosquitoes is to keep off malaria.
Of course, there are other weapons besides kerosene, mosquito-nets, and wire gauze in the campaign against malaria. There is the removal of the white man's factories, offices, and barracks from the immediate neighbourhood of native huts full of black babies full of the germs of the disease. There is State-aided distribution of quinine, which is giving splendid results in Italy, but is hardly applicable to Africa. There are the major works of drainage and of engineering ; there is the inspection of native schools and the treatment of the infective children : "I have seen a large class of native children," says Ross, "almost all of whom were suffering at the time from fever or enlargement of the spleen, being taught the dates of accession of the Plantagenet Kings." It is the children who are the danger to the white man. Tin adult natives mostly are free from the parasite ; but Kocl found it in the blood of eighty per cent, of the native childree in New Guinea.
All these subjects, and all the pathology of the disease, and the phases of the parasite in its alternate hosts, and much else that is for the doctors, not for the laity, are fully and wisely treated in this fine book. Not the least valuable and fascinating chapters are the special articles by experts in diverse parts of the world. These chapters (pp. 332-619) tell of the blessed work in the United States, Panama, West Indies, Jamaica, Amazon Region, South Brazil, Spain, Italy, Creece, German Possessions, French Possessions, Egypt, Khartoum, South Africa, Durban, Malay States, and Japan ; there are also chapters by Colonel Melville and Major Fowler on the care of troops in peace and in war. We have Gorges writing on Panama, Boyce on the West Indies, Celli on Italy, Andrew Balfour on Khartoum, and so forth. The book is well illustrated, not only with diagrams and sketches, but with twenty-six admirable full- page photographs. It would be hard to find a better history of the decline and fall of malaria.
It is the plain duty of all of us to know this most wonderful bit of the record of science; never was any history of pro- founder interest. The tragedy of Walcheren, the tragedy of the French Expedition (1895) to Madagascar, the dismal story of the malaria in Mauritius in 1866-67, should be read by everybody. Then read the present happy successes : the work of the Anti-Malaria League in Greece, the work of the Government in Italy, and that supreme instance, the work achieved in Havana and in Panama. For centuries and centuries man had believed in pestilential vapours and telluric influences ; then Laveran came along with his
microscope, and brought with him the beginnings of all our knowledge of the cause of malaria. Laveran's discovery of the Plasmodium malaria in 1880 did more for the world's health and strength and wealth than can be told in any book.
Previous page
