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PUBLIC RECORD OFFICE

Reference :-

سلسسلسلا

C.O.885

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ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH---NOT TO

PÚBLIC RECORD OFFICE, LONDON

(e.)

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That in every bedroom, mess-room, and office in Government buildings, a notice which Dr. Manson has been good enough to prepare on Malaria, its cause and prevention-be exhibited.”

If sufficient copies (roughly about 150) be sent out I will see to this being done. (f.)

"That one or more officers, medical if possible, be appointed to inspect, instruct in, and superintend the carrying out of such measures as may be adopted for the prevention of the transmission of malaria by mosquito bite."

A Medical Officer of Health has been applied for, and a scheme for a sanitary Department has received your approval, and has been sent home. If sanctioned this suggestion will be carried out.

(g.). "That it be suggested to Governors to note and give publicity to any practical demonstration and proof of the theory that residence in mosquito-proof dwellings diminishes the risk of infection."

The British Central Africa Gazette '—the official organ of the Administration- has before now published an account of an experiment carried out under the Colonial Office, acting under Dr. Manson's advice, and its columns are always open for any articles bearing on this subject which Medical Officers may care to contribute.

(h.) "That the Crown Agents for the Colonies be requested to arrange a supply of suitable wire gauze and mosquito netting if available, patterns of which should be easily accessible." This is a matter for the authorities at home. The Crown Agents were written to on the 8th of August last, and asked to supply samples, but no reply has yet been received from them.

(i.) "That all officials on first going out to malarial Colonies be advised to pro- cure mosquito nets."

If suggestion (d) be assented to there will be no need for this. If officials be advised to procure mosquito nets they should also be warned as to the importance of destroying the breeding grounds and other sources of supply of mosquitoes round their quarters. Anopheles as well as culices bite and infect through the day as well as at night.

Officials and the white population of this country generally now understand, and for the main part believe in, the connection of mosquitoes with malaria. At the same time the majority of them do not sufficiently consider the details of the question or take enough care to avoid all possible chances of diminishing infection. As prov- ing this statement I might mention the case of an official in a station on the Lake who forwarded me a number of mosquitoes by last mail in answer to a request. He has been many years in the Protectorate, and yet he sent me a tube containing seven anopheles mosquitoes, which were gorged with blood, and which he writes he had caught that morning inside his net." As has been said in one of the Malaria Committee's Reports" the misuse of mosquito nets by Europeans is astonishing."

Under the conditions of heat and moisture with germ growth so active in such a climate as is the case in British Central Africa, general hyginic precautions can greatly lessen the sick rate (both black and white).

Might I therefore, respectfully point out the importance of future candidates for medical service here being required to show some proficiency in tropical sanitary knowledge before being appointed. The high sick and mortality rates do not begin and end with malarial fevers alone. Dysentery, liver and bowel complaints, and many other diseases and epidemics are present to a degree which, as pointed out in a former report, is largely preventible. As in other countries it is prophylaxis, and not cure which will have to be looked to to improve the health conditions in this Pro- tectorate, and a system of sanatoria will greatly help this.

I have, &c.,

G. DOUGLAS GRAY, M.D.,

Principal Medical Officer.

His Majesty's Commissioner and Consul-General,

British Central Africa Administration,

Zomba.

Enclosure 2 in No. 82.

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gestions for malarial prophylaxis on general principles; but I fear that they would not be applicable to this particular station for various reasons; but since I have been here (fourteen) months) the public health has materially altered for the better.

Being Town Clerk as well as Medical Officer I have always had men at my com- mand to thoroughly carry out all my ideas, which may be of some slight use to other Medical Officers. I have had the banks of the Ruo properly cleared of all vegetable matter and kept constantly clean with the effect of destroying almost entirely a most fertile breeding ground for mosquitoes. All unoccupied plots are kept cleaned at the expense of the owners, which I venture to think has been of material assistance in destroying breeding grounds.

Pools and stagnant water have as far as possible been filled in and vegetation destroyed. We have also endeavoured to keep a space between the township and the river Zembi cleared of grass, &c.

Special attention has been paid to native houses, &c., which have been placed apart from European dwellings, and kept clean by the various employers of native labour.

As to the introduction of special mosquito-proof houses, wire gauze, &c., I fear that they would be of little or no use, as they undoubtedly interfere with the free passage of air, a most important matter in a station liable to extremes of heat, such as this, my own experience being that people would much prefer to be bitten by mosquitoes than to sacrifice what little breeze there is during the hot season.

As regards the proportion of anopheles mosquito to the culex, it differs very markedly during the wet and dry months. I should roughly estimate that during the dry season it is about 30-1, whilst in the wet season the culex would exceed the ano- pheles by some 2-1; but I will study the matter and inform you more fully at some later time.

As to the question of assistance, financial or otherwise, I see no immediate need for it, as what improvements we make in the sanitary condition of the station are casily met by the funds at the disposal of the Town Council.

It is reported that a railway will be commenced at no very distant date, from Chiromo, but of that I am unable to speak definitely; in the event of such an occur- rence, of course things sanitary would have to be carried out on a much larger

scale.

The Principal Medical Officer,

SIR,

Zomba.

I have, &c.,

PELHAM WYKESMITH.

Enclosure 3 in No. 82.

September 5, 1901.

I HAVE the honour to forward to you notes on the Committee's report, I am afraid I have not had enough experience of the country to allow of my opinion being of much value. If even half the recommendations could be carried out, there would be a lot of difference.

has

Mosquitoes could be diminished here most certainly. I am told that formerly, there were numbers of them. Bush has been cleared in the township, and a little round about. The gombe on the West side has been cleared. This, I presume, been the cause of the diminution. The opposite gombe is being cleared, and up and down the river. on the township side the clearing is being extended. This will bably have the effect of still further reducing the mosquito.

pro-

Proportion of anopheles to culices. Out in the district I have seen culices frequently; but in Fort Johnston I have only seen one or two. At this season, how- ever, mosquitoes are few. Practically, one only sees those that get under the net. These have all been anopheles in the medical officer's house.

In conclusion, if men and money are provided this station can be made healthier.

I have, &c.,

H. BONAR DODDS, M.B.,

Medical Officer, Fort Johnston.

SIR,

Chiromo, August 15, 1901. I HAVE the honour to inform you that I am in receipt of your favour of 7th instant, enclosing reports A., B. and C. of the Malarial Commission, also the recom- mendations for prevention of malaria. I most thoroughly approve of all the sug-

To Principal Medical Officer.

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PUBLIC RECORD OFFICE

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C.O.885

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| ALLY WITHOUT PERMISSION OF THE

COPYRIGHT PHOTOGRAPH-NOT TO BE REPRODUCED PHOTOGRAPHIC-

PUBLIC RECORD OFFICE, LONDON

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Re recommendations of Mr. Chamberlain's Committee for prevention of

Malaria.

Fort Johnston, September 5, 1901. Recommendation 1. In regard to Fort Johnston; (a) jungle may be cleared fairly easily. A considerable clearance has already been done, and should be continued. (b) stagnant pools may be filled up. Several gardens on the gombe have pools. I understand that brick clay pits do not produce anopheles. (c) there should be no great difficulty in moving native quarters at present. Later on, when things are more established, the difficulty will be greater. (d) high ground-very little round here.

2. I think a portion of verandah might very easily be rendered mosquito proof. It need not be large.

3. In what way is it the general practice already to destroy mosquitoes which enter rooms? All windows and doors are open-necessarily. Pyrethrum for burn- ing might be supplied unless there is a better method of destroying them. What are other methods?

4. All officials use nets, I believe.

5. Such an educational statement might be useful; but everyone knows the theory, though few really act on their knowledge with any thoroughness.

6. An officer with power and means could do a lot.

7.

8.

9. To render a whole building proof would be stuffy in the hot scason, but not so bad in the cold. Besides, there are anopheles in comparatively cool countries where the gauze would let in quite enough air. I think a proof room on the verandah is an excellent idea.

SIR,

Enclosure 4 in No. 82.

The Liverpool School of Tropical Medicine,

B 10, Exchange Buildings, Liverpool,

April 14, 1902. I HAVE to acknowledge receipt of your letter of 28th of February and enclosures, both of which have been submitted to Major Ross.

I now have pleasure in returning the report by the Principal Medical Officer of the British Central Africa Protectorate, together with Major Ross's observations thereon.

I have also to acknowledge receipt of your letter of the 3rd of April, transmitting copy of a despatch from His Majesty's Commissioner in the East African Pro- tectorate, enclosing Reports on Malaria by the Medical Officer of the Protectorate, which will be placed in the Library of the School.

The Under Secretary of State

for Foreign Affairs.

I am,

&c.,

A. H. MILNE.

School of Tropical Medicine, Thompson-Yates Laboratory,

MY DEAR Mr. MILNE,

University College, Liverpool, April 12, 1902.

I HAVE read with great interest the report of Dr. Gray, Principal Medical Officer of the British Central African Protectorate, and the reports which he encloses. I am most impressed with that of Dr. Pelham Wykesmith, from Chiromo. Instead of arguing about difficulties, he has used the means at his disposal in the best possible manner, that is by cleaning up the area in his charge, and he is consequently able to report good results already. Dr. Dodd appears also to be in the right way, and from what he says Fort Johnston ought to be easily rendered healthy by clearing up the breeding grounds of mosquitoes. Dr. Gray's report seems to me a most able, but perhaps, a little pessimistic, criticism of the recommendations of Mr. Chamberlain's Committee.

2. I may say at once that I do not like the suggestions of that Committee. They appear to me to be mostly of an academic nature. All the advice about wire gauze, segregation, providing rooms with means for the destruction of mosquitoes,

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putting up notices, and so on, is not of primary importance. Some of these methods will prove to be very expensive, and most of them depend for success on the faith or the energy of private persons a serious objection. The same can be said of Koch's method of forcing people to take quinine.

3. In the great majority of stations by far the best and cheapest way of dealing with malaria is that used by Dr. Wykesmith—namely, simply to employ the ordinary conservancy and maintenance gangs of the station (as usual, at the expense of the station funds) for removing pots, tubs, broken bottles, &c., for filling up puddles and pits, cutting down vegetation, and oiling waters which cannot be drained. The experi- ence of Sierra Leone (from which I have just returned), of Havana and of other places, absolutely demonstrates the fact that mosquitoes can be vastly reduced in this manner, a fact, however, which there never was any real reason to doubt. Dr. Howard, Ento- mologist of the United States Department of Agriculture, agrees with me (and I think we have had a more practical experience of mosquitoes than most writers on the subject) that it is probably always possible to make a large reduction of mosquitoes anywhere. The cost will usually be little. At Freetown, Sierra Leone (30,000 inhabi- tants), after eight months' operations, including cutting numerous drains through solid rock, cementing channels and rock-holes, and clearing out 2,250 cart loads of tins and broken bottles, we have spent less than £1,000 (including the superintendent's salary); with the result that at my recent visit I did not see nor hear a single mosquito dur- ing eight days in the rooms given to me at Government House, while from all accounts very few were to be seen in the place, which formerly swarmed with them. Similarly Havana reports a reduction of 90 per cent. in the mosquitoes. For small stations, all that is required is to direct the medical officer in charge of the sanitation to hire two or three intelligent natives in addition to the sanitary gangs and set them to clean and dry the place from a centre outwards. The cost will probably work out at much less than that of furnishing even a few houses with wire gauze, and far less than that of segregation; while the measure will protect natives as well as Europeans, and will add greatly to the general cleanliness of the place. Of course, the measure must be continued indefinitely: but, after the initial filling up of puddles, &c., it ranks only as part of the ordinary conservancy of a station.

4. In my opinion wire-gauze-proofing is only required in very water-logged places, or for isolated houses; and I would not think of such an expensive measure as segre gation (for old stations) until cheaper measures had been tried. But I consider that ordinary mosquito nets should be invariably employed during sleep in the tropics, whether mosquitoes are in evidence or not.

5. I have no remarks to make about the excellent reports from Dr. Macdonald (East Africa).

Yours, &c.,

33846

SIR,

RONALD ROSS, F.R.C.S., D.P.H., F.R.S.

No. 83.

GOLD COAST.

MR. CHAMBERLAIN to GOVERNOR MAJOR NATHAN.

(No. 242.)

Downing Street, April 23, 1902.

I HAVE the honour to acknowledge the receipt of your despatch, No. 435, of the 6th of September,* transmitting, in reply to my circulars of the 20th and 25th of April, 1901,† the observations of Dr. Henderson on the subject of the diminution of the risk from malaria in tropical countries, together with your own suggestions thereon.

2. With reference to the 5th paragraph of your despatch, I would recall your attention to my despatch," General," of the 10th of October last, respecting a specially adapted lamp which has been suggested as suitable for use in rooms for the purpose of destroying mosquitoes, and I have since learnt from the Governor of Lagos that those sent to that Colony have been favourably reported on by the Acting Chief Medical Officer there,

* No. 51.

Nos. 11 and 14.

33912: not printed, § See 14551; not printed,