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present be brought about. The destruction of Anopheles larvæ was, at first sight, so effective a means of getting rid of malaria that schemes for extensive destruction had many advocates. In our own experience the outlook has become less hopeful the more the habits of Anopheles have become known, and our opinion of the practicability of such operations has become gradually subverted by the practical experience of the difficulty of undertaking effective measures on a large scale. If drainage can be efficiently carried out over a particular area. it would, we believe, be successful in diminishing native malaria, but the conditions surrounding each case must determine to what extent such measures can be applied.

2. The prevention of malaria in Europeans.

In 1900, working on the Gold Coast, we advocated the protection of Europeans in Africa as being at present the proper and legitimate object of our limited resources in Africa. We gave reasons for believing that a system of segregation from the native, carried out as opportunity offered, would be far more effective than any other prophylactic | measure within our power. We have already seen that the malarial fever to which the European is subject is due to the fact that he lives amidst the natives, or with the native at his door. We would emphasize again the fact that these conditions have impressed themselves upon us so vividly, because our experience of them has not been that of a passing observation, but one derived from actually living under them. We have enjoyed the hospitality of very many Europeans, and have slept in the bungalows and quarters of officials, railway engineers, missionaries, settlers, traders, in quarters in the centre of native camps, always with the inevitable native huts in the compound, and in all, these concitions held good. Realising the danger of sleeping under such conditions we succeeded in preserving our health only by most constant and unremitting care in the use of per- sonal precautions. Such precautions we, however, found were generally so irksome that men preferred to run the risk of infection rather than bestow the necessary attention to them. Although we used mosquito nets we found it necessary to employ an extraordin- ary and troublesome degree of care in their use in such conditions as are usual in African up-country stations, and we believe but few men would employ them with sufficient care to avoid infection in such places. Similarly with regard to houses protected with wire gauze. Even where the oppressiveness of the climate would not preclude their use, we consider that it is only by a constant vigilance that but few inen would exercise, that such measures could be successful,

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As a preliminary step to all other prophylactic measures, and as one likely more than any other to minimise European malaria we, therefore, advocate Segregation from the Native."

Since we first put forward segregation as a principle to be followed whenever eppertunity offered, it has been recognised by some authorities* as the first law of hygiene in the tropics; on the other haul it has met with criticism. Much of the latter is evidently based on mistaken notions of what is meant by segregation, and what segre- gation entails. Segregation as an anti-malarial measure does not, for instance, mean the avoidance of intercourse with the native. Nor does it mean a lessening of the power of control of the native. It has been said that segregation means giving up a country. Such a notion could only arise from a complete misconception of what is meant by segre- gation in this connection. the fact that in India segregation is almost universal seems to us to effectively meet such objections. In India we do not, except rarely, find European dwellings and native quarters crowded together, but almost always a well-designed European quarter, quite distinct from the native bazaar. Yet in India there can be no question of loss of touch with the natives-rather on the contrary, an increased respect on their part.

To talk also of the impossibility or impracticability of segregation in Africa is absurd, because a most excellently carried out scheme of segregation already exists at Accra (Victoriaborg), and to a less extent at ld Calabar, both which places are noted on the West Coast for their comparative healthiness. Moreover, since we first advocated such measures they have been advocated also by Annett and Dutton (2nd Liverpool Ex- pedition) as applicable, above any others, to Nigeria. These authors had actual experience,

* NOTE.- Manson. "Practitioner," 1900. Aunett and Dutton, 2nd Expedition Liverpool School.