INTERESTING letters by Mr. D. E. Hutchins and Mr. F. R. Mallet have recently appeared in NATURE, suggesting the possibility of there being some other route for infection in malaria besides that by the bite of Anopheles. Suggestions of this kind always appear to me to give rise to the questions, (a) whether the facts are really as stated? and (b) whether, if even this is the case, they cannot be explained by the mosquito theory? The notion that clearing jungle causes fever is very widely spread; but this does not prove that it is true. Granting that it is true, it may possibly be explained on the ground (a) that persons engaged in clearing jungle and laying out new plantations are not likely to be so well housed as those who live in established settlements; (b) that any hard labour encourages relapses of fever among coolies and others who have already been infected; and (c) that, as shown by Christophers and Stephens, jungle often contains large numbers of Anopheles. The frequent statements one sees, to the effect that malaria has prevailed largely when mosquitoes were few, are generally too vague to be of value, because it is not added whether the cases were relapses or fresh infections, or to what kind the “few” mosquitoes present belonged. When a man says that mosquitoes are numerous he generally refers to the genus Culex, which probably assert themselves more than do Anopheles. The idea that the water of the rivers of western India can cause fever when it is drunk is certainly opposed to my personal experience. In 1891 I went fishing with Mr. G. Tait, of Bangalore, in the River Bhawani, near Ootacamund. I remember that at the time I did not think that fever could be acquired by drinking such water, and I used daily to drink the unboiled water of this river (which flows amongst thick jungle). I remained quite free from fever, without taking quinine; but Mr. Tait was afterwards attacked. So far as I remember (but I am not sure), he had refused to drink Bhawani water; but I am not certain that his fever was malarial. Again, the idea that malaria is absent in the Nilgiri Hills round Ootacamund unless the soil is turned does not accord with my personal experiences. I acquired fever at Kalhutti (5000 feet above sea-level) in 1897, when I was investigating the disease in the Sigur Ghat. I thought at the time that I had acquired it in the plains below, but, in the light of our present knowledge, have little doubt that I became infected in the dak-bungalow at Kalhutti, where a succession of kitmutgars and their families had been taken ill. I noted particularly at the time that there was no freshly turned soil in the neighbourhood of the bungalow. Lastly, the case mentioned by Mr. D. E. Hutchins, namely that of a medically authenticated case of malaria being produced by fresh earth carried past a window in baskets by coolies, seems to me to be open to criticism. Which fact was medically authenticated—the fact that the patient suffered from malaria, or that his malaria was caused by the earth carried past in baskets? I can understand the first fact being certified by a doctor, but scarcely the second. How did the doctor prove that the fever was produced by the earth in the baskets? It seems to me that the only way in which he could have done so in a trustworthy and scientific manner would have been to infect a second person by having the baskets carried past a second time. I doubt whether such instances—and we see hundreds of them in the Press—will bear close examination. Those who cite cases of fever apparently due to freshly-turned earth, seem to forget that there are millions of people constantly engaged in digging without suffering from the disease more than others do.
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