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I believe that the breeze produced by electrical fans (if properly situated) is most useful in preventing mosquitoes remaining in a room, and there is electrical power in Colombo.

3. Secondary matters:-

Drugs. I believe that quinine given to an infected person will prevent the propu- gation of the parasites and therefore prevent an attack of fever while living in a country where there is great risk of anopheles infection.

Food. In Ceylon there is a belief that with improved food malaria disappears.

If an infected person is starved he appears much more liable to develop the disease than at other times.

In my opinion this is simply that the resisting power of the body (whatever that may be against disease is lowered.

Clothing-Naturally people who go about practically naked afford more chances to the anopheles to bite them than those clothed.

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III. The prevention of the Infection of the Anopheles by Man.

This, in my opinion, is a most important part of prophylaxis. If the anopheles has not got the malarial germ in its body it cannot propagate malaria. As far as we know the only means it has of acquiring these particular malarial germs is by sucking the blood of a human being suffering from malaria.

It is therefore of extreme importance to prevent

patient.

The subject may be considered under two heads :-

(A) Malarial Fever Patients.

(B) The Poorer Classes.

A.Malarial fever patients.

from attacking a malarial

In order to protect the mosquito against malarial fever patients, two methods may be adopted at one and the same time, viz. :-

1. Mechanical methods.

2. Administration of quinine.

1-Mechanical methods:-

Personally believe that any one ufïring from malarial fever in a country in which the anopheles abounds is "a danger to public health as from such a patient the anopheles can obtain the parasite and then proceed a few days later to infect a healthy person.

Therefore I consider that there ought to be gnat-proof wards in hospitals in very malarious places, with the doors, windows, and ventilators being capable of being closed at dusk by means of copper wire gauze so that however much people may be exposed in their own houses, they may be protected in the hospital, which would also serve as an object lesson to the native.

In private houses mosquito netting could be used, doors could be protected by double curtains of mosquito netting so arranged, by being fixed to upper and side parts of the doorway, and having the lower part weighted by small shot or small pieces of lead, so that a person could enter by separating the two halves, which could readily be placed in position after entry.

Windows could be protected by mosquito netting.

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If protected against the mosquito in this manner, the malarial patient would not be able to infect it, and therefore it would be unable to spread the disease.

Protection by mosquito curtains would have to be carried out rigidly for about two to three months after convalescence, for then the crescents are in the blood and the mosquito could be readily infected.

These methods are of course not applicable to the houses of the poor classes. 2. Administration of quinine :-

There is no doubt that quinine kills the parasite, and it should be continued for some time after convalescence so as to attempt to rid the blood of the parasite, and thereby to prevent the mosquito getting into its body.

I think that this is the best way to deal with the poor classes, who will not use mechanical protection.

Every facility should be afforded to obtain quinine in order that they may con- tinue this treatment for a length of time after convalescence.

I do not believe in wholesale or compulsory quinine treatment, which has been advocated.

B. The Poor Classes.

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Two methods have been suggested in order to deal with the poor classes who are too ignorant to take precautions.

A. Segregation.

B.Quinine Treatment.

A.-Segregation:--

After a careful consideration of this as regards Ceylon I am convinced that it is impracticable. Ceylon has long been inhabited by Europeans, and there is no way to separate the poor from the rich classes.

B.-Quinine Treatment:--

This has already been mentioned.

PART IV.-The Summary.

In brief my belief is that:-

I.—The medical, and apothecary services and the general public should receive

education suitable to their requirements in malaria.

II. That by the aid of the educated medical and apothecary services malarial -

districts should be thoroughly investigated before any steps are taken, and those methods of prevention used which are found most suitable to the individual case.

Of the methods of prevention which appear to me most suitable to malarial places

in Ceylon in general the following may be mentioned:—

I-Primary Importance.

A.-The rendering of the wards of hospitals and other Governmental residences

in malarial places gnat proof. B.-That people in malarial districts should be encouraged to render their bun-

galows gnat-proof.

c.-Sanitation should be carried out with regard to pools, compounds, streams,

&c., in malarial districts.

D.-The administration of quinine for a length of time after convalescence,

especially in the poor classes.

II. Secondary Importance.

The destruction of the larvae by crude petroleum might be carried out wherever feasible.

Practical Application.

My belief is that if the Governmental residences, eg, police barracks, hospitals, &c., in very malarious places were rendered gnat-proof as an object lesson, then Europeans and natives, seeing the actual application of the suggestions, would be more likely to apply the same to their own residences.

A THEORY to explain how Man and the Mosquito originally became infected with the Malarial Germ.

At a lecture on " Malaria and the Mosquito," two points of considerable practical interest were raised by Dr. Perry, P.C.M.O."

1. Is it not possible that the infection of man may take place by some other

means than the mosquito?

2. If it is not possible: how did the cycle of the life history in man and the

mosquito start?

It appears to me to be important to state a theory which will attempt to give reasons why the mosquito is probably the only means of infection at the present time, and also to show how the infection started. The reason why it is important to do this is to try to leave no possible excuse for any person to avoid taking reasonable and simple precautions to prevent himself or herself becoming infected with malarial fever, as the actual demonstration of the fact that the mosquito is the cause has already been given. These two questions can only be answered by considering the probable evolution of the malarial parasite, and though, of course, only a theory, and not open to any proof, will indicate a possible path of infection.