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Original Page Scans RURAL SANITATION IN THE TROPICS BEING NOTES AND OBSERVATIONS IN THE MALAY ARCHIPELAGO, PANAMA AND OTHER LANDS BY MALCOLM WATSON M.D., C.M., D.P.H. WITH ILLUSTRATIONS LO N DO N JOHN MURRAY, ALBEMARLE STREET, W. 1 9 1 5 1 TO SIR RONALD ROSS, K.C. B. D.P.H.. F.R.C.S., M.D., D.Sc., LL.D., F.R.S. NOBEL LAUR_EArE I DEDICATE THIS BOOK NOT ONLY As A. TOKEN or PERSONAL ESTEEM AND FRIENDSHIP BUT ALSO As A TRIBUTE or PROFOUND ADMIRATION FOR HIS GENIUS AND HIS, WORK 1 About this book As of 2015, this remarkable book is exactly one hundred years old. It is written by an outstanding pioneer of malaria con- trol. Sir Malcolm Watson implemented and oversaw the first successful effort to control malaria when serving as a sanitar- ian in the then British colony of Malaya. In the first part this book, he describes those efforts. Further on, he reports on his visit to the Panama Canal Zone, where the construction of the Canal was in full swing. The conditions of the climate, exacerbated by the environmental effects of the construc- tion itself, were extremely conducive to the spread of yel- low fever and malaria, which had caused the previous French construction project to collapse. When the Americans took over, they brought in Colonel Gorgas, who had been part of the team that had identi- fied the transmission mode of yellow fever and subsequently driven the disease from Havana, Cuba. In Panama, he cre- ated a uniquely effective sanitary organization that achieved elimination of yellow fever and tight control of malaria, thus ensuring the success of the construction project. Considering that malaria is often perceived as a chal- lenge that is almost insurmountable even in our scientifi- cally advanced age, it is quite startling to read how pioneers like Watson and Gorgas managed to get the better of it, using nothing more than drainage of swamps and creeks, oiling of standing water, common sense, and meticulous follow-up. This book remains relevant 100 years on. About this edition I obtained the book from archive.org, where you can find the original page scans. The reproduction here is unaltered, except that empty pages were removed, some of the pages were freed from marks and spots, and the digital file format was changed so as to reduce file size, add navigational struc- ture, and make the text searchable. A reformatted and edited version is also available from my website. Michael Palmer, April 30th 2015 CONTENTS CHAPTER I PAGE INTRODUCTORY . I CHAPTER II BRITISH MALAYA History. Klang. Choice of Anti-malaria Method. Port Swettenham. Results. Rural Malaria. Malaria Easily Controlled in Flat Land. Hill Land. Persistence of Malaria. Subsoil Drainage and its Problems. The Area to be Drained. Stone Covering. Spleen Rates and Death-rates . 03 CHAPTER III BRITISH MALAYA (contznuea) Malaria Advisory Board, Federated Malay States : its Objects. Malaria in Kuala Lumpur. Quinine. Pictorial Card. Research. Terentang Estate Experiment. The Anti- malaria Committee of the Straits Settlements. Malaria in Singapore. Rice Fields and Malaria. Water-supplies .in the Federated Malay States. The Coast Water Scheme. Rules for Estate Sanitation. Beri-Beri . 2o . CHAPTER IV QUININE PROPHYLAXISIN ITALY . Distribution of Malaria in Italy. A Economic Importance of the Disease. Its Connection with Swamps. Physical Conditions Favouring Malaria. Drainage Difficulties. Quinine. Councilof Health . 40 IX 1 CONTENTS CHAPTER I PAGE INTRODUCTORY . I CHAPTER II BRITISH MALAYA History. Klang. Choice of Anti-malaria Method. Port Swettenham. Results. Rural Malaria. Malaria Easily Controlled in Flat Land. Hill Land. Persistence of Malaria. Subsoil Drainage and its Problems. The Area to be Drained. Stone Covering. Spleen Rates and Death-rates . 03 CHAPTER III BRITISH MALAYA (contznuea) Malaria Advisory Board, Federated Malay States : its Objects. Malaria in Kuala Lumpur. Quinine. Pictorial Card. Research. Terentang Estate Experiment. The Anti- malaria Committee of the Straits Settlements. Malaria in Singapore. Rice Fields and Malaria. Water-supplies .in the Federated Malay States. The Coast Water Scheme. Rules for Estate Sanitation. Beri-Beri . 2o . CHAPTER IV QUININE PROPHYLAXISIN ITALY . Distribution of Malaria in Italy. A Economic Importance of the Disease. Its Connection with Swamps. Physical Conditions Favouring Malaria. Drainage Difficulties. Quinine. Councilof Health . 40 IX 1 x CONTENTS CHAPTER V MALARIA IN INDIA PAGE Malayan and Indian Observations, a Parallel. The Human Factor in Malaria. Jungle in Lower Bengal. Hill Land in Central Provinces. The Identication of Anopheles maculatus. The Duars. Jeypore Agency. Chota Nagpur. Ceylon . 47 CHAPTER VI NOTES ON SUMATRA Position. Belawan. Medan. Tobacco Cultivation. Tand- jong Kassau, a Healthy Estate. A. maculatus absent. The Hospital. Vital Statistics. Mosquitoes. Toentoen- gan, a Typical Hill Land Estate yet free from Malaria. Labour System in Sumatra. Deli Maatschappij. Hospital at Medan. Vital Statistics of Ten Thousand Coolies. Ankylostomiasis. Malaria. Dysentery. Principal Diseases. Medical Institute. Bekioen and Bandar Talu, Hill Land Estates. Sumatras Prole. Kuala Namoe Estate, formerly Malarious. Tandjong Morawa Hospital. Dr Schiiher. Rantau Pandjang. Malaria on the Sea Coast. Method of Obtaining Children for Spleen Examination. The Sumatra Highlands. The Military Road. A Canyon. Sudden Change in Vegetation. Brastagi: no Malaria ;_ many Anopheles in Rice Fields. List of Anopheles of North- east Sumatra. Conclusions . 59 CHAPTER VII HONG KONG AND PHILIPPINE.ISLANDS Hong Kong. Formosa. Philippine Islands. The Distribution of Anopheles in South and East Asia . 9o 1 CONTENTS xi CHAPTER VIII PANAMA PAGE History of Failures. Why the Americans began the Canal. Preparation for the Labour Force. My F ailureito Under- stand the Sanitary Work. Criticism of the Sanitary Work. First Impressions. Esjrit de Cams. Yellow Fever and Malaria in the Past. Yellow Fever among the French. Highest Oicials not Exempt. Doctors and Nurses Attacked. Death-rate of French Labourers. The Americans begin in 1904. Work temporarily abandoned in 1906. The last Yellow Fever Epidemic. Malaria . 99 CHAPTER IX PANAMA (co7ztz7zzaea) The Organisation of the Department of Sanitation. Signi- cance of the Name. The Three Sub-departments. Sanitary Inspection and Prevention. Hospitals and Board of Health Laboratory. The Geography of the Isthmus and Canal. The Tides of the Atlantic and of the Pacic. Temperature. Rainfall. Division into Sanitary Districts. The Area of Districts. The Chief Sanitary Inspectors Staff. Manual of Instructions for Sanitary Inspectors . 119 CHAPTER X PANAMA (co7ztz7zuea) Ancon and Balboa. Filling a Swamp. Soft Stone from Culebra Cut. Range Closet. Subsoil Drains. Hydraulic Fill. Screened Barracks. L Gatun. The Yellow Fever Ant. An Hydraulic Fill. Breeding Mosquitoes. Fish and Larvae. Y.M.C.A. Subsoil Drain Blocked. A Wire Drain. Native Tenements. Channels in Argillaceous Sandstone. A Sanitary lnspectors Oice. Miraores. Grass-burnt Drain. Rock Pools. The Anopheles Catch. Rio Grande Swamp. East Miraflores Dump. Camatillo Swamp. Larvacide and Oil used. Gorgona. Condensing Station. Reservoir Larvae in Debris. A. albimanus not in Streams. Algae. The Breeding-place of A. malefactor. 1 xii CONTENTS PAGE Oiling Swamps. No Clean-Weeding. The Mosquito Catch. Matachin. Larvae Found. No Pupae Allowed. Culverts Blocked. Swamp Vegetation in Panama. The Chagres River. Larva in Debris. Seaweed Grass. Bas Obispo. A Mosaic Breeding-place. The Cut. Large Population on its Banks. How Rainfall alters Oiling Areas. Las Cascadas. Drainage done with Brains. Larvae in Cattle Hoof-marks. Empire. Stegomyia Day. Prosecutions for Sanitary Offences. The Beginning of Wisdom. Culebra. Filling Blocks Drainage. An Unsatisfactory Latrine. Lady Complains of Mosquitoes. My Experience of Mosquitoes. Pedro Miguel. Oil- Tanks. Oil-Boat. Locks. Rio Pedro Miguel. No Larvae. Refuse Destructor. Pick-up Day. Paraiso. The Cut. Cucaracha Slide. Iced Water. Colon. Cristobal. Mount Hope. Houses on Piles. Original Town on a Coral Reef. Drainage. Spleen Rate in I904. Toro Point. Houses on Coral Beach. Swamp behind. Larvae in Stream. Reduction of Malaria, Corozal. Frijoles. Monte Lirio. The City ofPanama . 133 CHAPTER XI PANAMA (continued) Anti-malaria Methods. Drainage. Open Drains Dangerous in Dry Weather. Upkeep Expensive. Subsoil or Tile Drains. Stone Covering. Blockage. Wire Drains Cheap; Suitable only for Certain Countries. First Use of Tile Drains in Malaya. Oiling, Second to Drainage in Principle; First in Practice in Panama. Oiling System. Labour Saving. Cost of Labour. Sprayers. Drip Barrels. Larvacide Manufacture; Value; Disadvantages. Screen- ing. The New House. Quality of Gauze. Are Screened Houses Mosquito Traps? Screening Abolished for Silver Married Quarters -in 1909. Extension of Oiling. Number who Live in Screened Houses. Quinine . 168 CHAPTER XII PANAMA (continued) On Mosquitoes. Aedes (Stegom_yz(z) calapus and Yellow Fever. Lives in Rain-water, not in Pool. Asias Danger. Tokyo. West Africa. Anopheles and Malaria. Species on Zone. 1 CONTENTS xiii PAGE Anopheles albimanus. Dr Darlings Observations Outside the Zone. A. argyrztar:z.r. A. p.rezmopunctzpennzs.A. male/actor. A. eisem. A. cruzzl On Anopheles Adults. Distance of Flight. Flights at Gatun. Miraores and Corozal. The Effect of Wind on, and the Diffusion of, Mosquitoes. Mosquito Traps . 184 CHAPTER XIII PANAMA (co7ztzmtea) Weekly and Monthly Inspection Reports by Sanitary Inspectors and District Physicians. Water-supplies.
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