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The fac that socia factors, an more particularly the standar oflivin of the population, play an important role in his matter, andespeciali that the resistanc against the effect o chroni malaria increases in proportion to the aisins of this standard is illustraled
by a communicationis Senevet 'β, who reporis:
seem to e caused by the decreased number of breedins-places for the Anophetes a more seneralis of quinin and above alliva generat improvement of the standar of livinu . In Dalmatia. whicli is considere one of the malaria countries of Europe the measures adopte are*' fight against i serm-carriers
by quinine 2 flyin Anophetes by educationis the population, and the se of insecticides and fauete 3 the reedin places filiins up,
clearing drainase reclamations destruction os larUaei.
The Board os Public Health an Socia wellare in Roumania' 'reporis that oumani no adays is certainly one of the most infested region o Europe. The Public Health Service not ein able tofish the malaria by main drainase, land drainas and other sanitation orks tried the sterilisationis the infested areas by the use of quinine in l90 for therars time. The resulis ere ver satisfactorY. Ali ho oo the quininetreaiment kepi ree rom everriti the close of the campaisn. Generalty the experiments illi prophylacti quinine in the villase Belitori in the deparimentis Teleorman have been successsul. Dr Gorasco concludes Foris in the proximit os lakes and mctrShes, prophylacti quinin is the furest means to fish malaria. we have not et started illi the destructionis mosquitos. Sufficienti instructe officiat a weli a the mone to ove the
lli future u hope lies in drainas and sanitation ork, etc.when we considerethat for Moldavia and the Banks of the Danube, l. l37.992 hectares helonito the ooded area one understand that the neceSSar expenses for makin this ursace healthnare of litile Account, compared illi the enormous aduantasses in arabie tandan improvementis uenera health which wouldi the result . The oviet Government in Russis has done iis ulmos torash the stupendous epidemi os malaria hicli devastates that country Sanit alion orco a large scale is for the present, ut o question naccount of the extent of the area and the lac o money. An anti- malaria service has been created with over 100 centres to distribute
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166 HE RECENT ANTI MALARIA CAMPAIGN
Theseople' Commissariat for the Medicat Service also publisheda series of rules an resulation respectins his of hic me may mentio that unde No 10: Instructions for the preventive administrationis quinine . Finalty, e quot hom the bove mentione publicationis r. Dobreitzer pase 70: The hortas of quinin in the countr is ne of the principalobstacles encountere in the trussi against malaria. Durins theblochade Russia was almos entiret without it This in part explainsthe enormous accumulationis malaria sufferer and the extraordinary
enormous Is e estimate meret a 20 gram the annua quantity of quinin necessar for each malaria sufferer it is found that in order
A resard the importance of the epidemic Machengi' says: The effect of the epidemicin the future o Russia ill probablyprove to e reater tha that of the evolution Fromin healthycountr inhabite by a virile energetic easant population andentiret non- malaria throughout iis reater extent the whole of South Russi is no probabi the mos malaria countr in theworid. It is probable that a rea degeneratio comparabie illithe effectis malaria o ancient Greec mill in the ex 20 years alter the type of the whole populatio of these Cossac districis and wil threaten to overwhelm the res of Russia. The sam author in another publication ' says: 'Lars sanitation works are for the present impossibie, ut atteast quinine houldie supplied . The mission of the Societ o Friend of whom the author is a member has parti organised the anti-malariat work. A central bacteriologica laborator mit sub-laboratorie has been created and dispensaries hicli administer quinin locatly But even his is f
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smal importanc compare Wit the asines of the infecte area. Distributionis quinine has tot ver Stricti Supervised. In another instance' this riter states:
In wide distributionis quinine lies the ni hope . The Bulleti of the Committe os Public Healthy reporis: The fight against malaria is severely handicapped throus lach
Public Health to procure suffcient quinine and money the enormoustas of fightin the malaria in Russia. illi accomptished . Concerning the resulis Eme M. Christi' mentions: The Societ o Friend sent a nil to the Buzulu district in thelamine area Typhus claimed mos victim durin the winter and sprin o l92l-22 but durins the summe monilis there a an epidemi os malaria o an unusual seriousness. The deat rate as appalling. Measures consiste in the re distribution os quinine Patientchada attendis the clinic dati or a required totake quinine This ork was after ard extente to the villases in the neislibourhood. The resulis for Buzulu only show that in a ea the verageo recorde relapses an re-infections as 5 per cent. ith thesaia suppositio that the rea averas was not above lyper cent.
Conclusion The data here sive sito that the sh against malaria must notae based exclusivel o sanitation wor only nor clusivel o the distributionis quinine Oni Doma combinationo both method can the destre resulti expected which of the two halli preponderant is entiret dependentin loca conditions: but it ma be sat for the present that for ars areas with a dominant rura population the distribution o quinine combine with
Smal anti-larva measures is the mos economica way in resar tothe expenSeS, while, at the fame time it sive a direct result.
Variis modis bene fit et male . a favourite phrase of a well-known
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i68 HE RECENT ANTI MALARIA CAMPAIGN
Dutch physician, may also e taken as a motio for anti malaria ork the last wor has not et been spolien it even looks ascis eare ni at the besinnins of the way whicli mill eadis to the solutio of the problem. Is me mantake the plough as a symbolis sanitation ork, me cancondens the present state of this question in the words:
The Liverpoo studies in malaria. Editorial l. m. med. Ass. 32, Marchra, 192q. p. 796. Henr C. Carier, International conferencein heali problems, held in Κingstown.
paludismo declaraona dei protectorado espassol en Marruecosa medios para combatirlo.
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51 Edm. Et Sergent, L. Parros. H. Foley, G. Seneνet G. Catanei Eludes epidemiolosique o prophylactique du paludisme, N. 21 O 22 campasne en Alserie en 192 l. 19224 1923. Aran. Inst. Pasteur. 33, No. 9, sept. 192q, p. 775.52 Edm. f. Sergens L. Parros M. Foley, G. Seneνet M. Catanei Eludes epidemiolosiques O prophylactiques du paludisme en Alserie. 922-1923. Arch. Inst. Pasteur Algerie a No. 3 l923, p. 26 l. 53 Ch. Vialasse La luit antipaludique a Maroc. Etat de la question O resume de campasne de l922. Arch. Inst. Pasteur Algerie, No. 3, 1923, p. 563. 5 H. Ziemann. Einises euere aus de Gebiete de Parasitoloste tropischen Pathologie O Hysiene Medietin. Κlinth, 20, No. 7, 23 Nov. 192q. p. 662.55 Proceedins of the ninth meetins of the Antimalariat advisor commission 22nd. Ma 1924. Dept. of health, Ierusalem. 56 I. . I le S I. Meilamann Malaria contro demonstrations in PalestinB, p. 69. Ierusalem. 1922.57 H. I. T. Bylmer, De malaria. Me eenisemanvultende opmerkinsen an H. de
62 B. Grassi, Revivisceneta temporanea della malaria in oscctna. An n. Igiene,
66 Paludisme en Roumante. Ministere de a sanie et de a preMoyctrice SociBle. Bucarest. 192q.