Within a few months of its publication by the Liverpool School of Tropical Medicine in 1911, the first edition of this book was sold out. A reprint was suggested, but as our knowledge at that time was increasing rapidly, I felt the book should be rewritten.
Visits to Sumatra, Panama, and British Guiana, the writing of Rural Sanitation in the Tropics, and the war, have all served to delay the issue of a new edition; but another, and perhaps the chief cause, was a disinclination to write during the progress of many anti-malaria schemes, and before they had reached fruition—in other words, a dislike to write of uncompleted work.
Whatever hesitation there may be elsewhere, mosquito reduction, as the method of stamping out malaria, has been so widely adopted throughout Malaya that each year always leaves work unfinished, as it also initiates new work, and sees the completion of what was begun in former years. But, however fascinating it is to gather in one harvest, and to look forward to the next, the need of the new workers for guidance is too great to allow of further delay in publishing.
Sir Ronald Ross pointed out in the first chapter of his Prevention of Malaria, that the work described in the first edition of this book recorded a new phase in anti-malarial work, namely the control of malaria by anopheline reduction in rural areas. From small beginnings in towns, the work has spread in ever-widening circles, and, I might add, in spite of an apparently ever-deepening complexity of the problem.
So far from the map of Malaya being evenly washed with the malarial taint, violent contrasts have been found in different parts, and widely different, often diametrically opposed, methods have been found necessary for its control. Some land, when covered with jungle, has been found to be malarial, and some non-malarial; some land has become healthy when cleared of jungle, and some has become intensely malarial when so treated; drainage frees some land from malaria, but some remains malarial; some land is malarial whether drained or undrained, whether under jungle or cleared of jungle; some rice fields are malarial, and some are non-malarial; while in a single ravine, the various insect inhabitants may come and go in the wondrous fashion of a fairy tale. In their stories of the little mouse-deer, the Malays have invented a “Puck,” who plays endless tricks on the other creatures of the forest. Sometimes I suspect he has been working his wiles on men and mosquitoes, and, uninvited, been taking an elfish interest in mosquito control, which we could gladly have excused.
Through the maze, however, the great truth discovered by Sir Ronald Ross has been an unfailing guide. But for that discovery no progress would have been possible; we would have been absolutely baffled and utterly lost; because of it, tens of thousands are alive today in Malaya who would have been dead, while the suffering from which the children have been saved is almost beyond belief.
From the mass of material available, it has been necessary to make some selection. Examples of the control of malaria in mangrove swamps, on plains, and on hills have been given, with plans and illustrations. It is hoped these will assist medical officers to control malaria under most conditions, and to suggest means of overcoming difficulties, even if a replica of the place and problem is not to be found in these pages. And I would forcibly impress on the beginner not to be daunted by apparent failure. The destruction of Anopheles always bears fruit, although, as this book shows, the full benefits may not be reaped for months or years.
Some readers may be interested in the development of our present ideas of malaria. For them portions of the previous edition have been retained and marked thus (1909). Although the record is of unbroken progress, scientific and practical, there are problems ahead. Yet in looking into the future, I can see—not far distant—the extension of the present methods, the evolution of new ones, and triumphs in averting death, in promoting happiness, prosperity and joy, more brilliant than any hitherto recorded in the history of medicine in the tropics.
I wish to acknowledge my indebtedness to Mr. C. Ward-Jackson for valued assistance, and for revising and correcting the proof sheets.
Klang, Federated Malay States,
23rd July 1921.