There are, finally, peculiarities in the local charging of the atmosphere with malaria which can be explained only in this manner. If the malarial miasm were composed of gaseous bodies emanating from the soil, or rather of chemical ferments formed beneath the ground and raised into the air by gases or watery vapor, the charging of the atmosphere with the specific poison ought to arrive at its maximum during the hottest part of the day, when the ground is heated the most by the sun's rays, and when the evaporation of water and all chemical actions attain their maximum intensity. But this is very different from what actually occurs. The local charging of the atmosphere is always less strong during the meridian hours than at the beginning and the end of the day, that is to say, after the rising, and especially after the setting, of the sun. Now it is precisely at these hours that the difference between the temperature of the lower layers of the atmosphere and that of the surface of the ground is the greatest, and that the ascending currents of air starting from the ground are the strongest. If malaria consists of solid particles contained in the soil, one may readily understand how their elevation en masse into the atmosphere should take place especially at these two periods of the day.
All these facts, which can be easily verified if the subject of malaria be studied on the spot and without any preconceived notions, explain the tendency which has always been manifested to attribute this specific poisoning of the air to a living organism which is multiplied in the soil; and they also explain the ardor with which hygienists have applied themselves to the production of the scientific proof.
Unfortunately the investigations undertaken for this end have for a long time been fruitless, for the preconceived paludal theory has led investigators to occupy themselves exclusively with the inferior organisms inhabiting marshes. Among these organisms they studied especially the hyphomycetes, which had already acquired so great an importance in dermatology; and their entire attention was concentrated upon the aquatic algae, without even taking the precaution to determine whether the varieties which they thought to be malarial were found in all malarious swamps, or whether they were capable of living within the human organism. It has thus happened that each observer has indicated as the cause of malaria a different variety of alga, whichever he found to be most abundant in the swampy ground that he had to examine. Thus Salisbury has indicated the palmella gemiasma, which is found with us in places perfectly free from malaria, while it is often wanting in malarious marshes in the center of Italy; Balestra, a species of alga which is as yet indeterminate; Bargellini, the palmogloea micrococca; Safford and Bartlett, the hydrogastrum granulatum; and Archer, the chitonoblastus oeruginosus. There is not a single one of these species the parasitic nature of which has been demonstrated; and as regards the two last named varieties, it can be positively denied that they are capable of producing a general infection, for the diameter of their spores and filaments is greater than that of the capillary blood vessels.
It was only in 1879 that Klebs and myself, after having been thoroughly freed, by a long series of preparatory studies, from the unfortunate paludal idea, undertook together some investigations in malarious districts of the most varied character, marshy and not marshy. We employed the system of fractional cultivation, making experiments on animals with the final products thus obtained. We felt ourselves justified in recognizing the malarial ferment in the schizomycete bacillus. The numerous researches made subsequently by us, and by many other observers, in the soil and in the air of several malarious localities, as well as in the blood and in the organs of men and animals specifically infected, have put it henceforth almost beyond doubt that we really have to do with a schizomycete. Very recently, MM. Marchiafava and Celli have succeeded in demonstrating that the germs of this schizomycete attack directly the red blood-globules, and destroy them, causing them to undergo a series of very characteristic changes which admit of easy verification, and which render certain the existence of a malarial infection.
Several observations made recently in Rome tend to demonstrate that the schizomycete of malaria does not always assume the complete bacillary form described by Klebs and myself; but this morphological question possesses no further interest for the hygienist. For him the essential thing is to know that he has to deal with a living ferment which can flourish in soils of very varied composition, and without the presence of which neither marshes nor stagnant pools of water are capable of producing malaria.
We must not think, however, that all earth containing this ferment is capable of poisoning the superjacent atmosphere. Popular experience, certain modern scientific investigation, and the facts which one can often verify when the soil, which was malarious in ancient times and which has since ceased to be so, is turned up to a great depth, all agree in proving that the ground remains inoffensive as long as it is not placed in certain conditions indispensable for the multiplication of this specific ferment. Up to this point the organism lives, so to speak, in an inert state, and may remain so during centuries without losing any of its deleterious power. There is nothing in this fact that ought to surprise us, since we know that the life and the power of evolution belonging to the seeds of plants of a much higher order than these vegetable organisms constituting ferments, may remain latent for centuries, and may then revive at once when these grains are placed in the conditions suitable for their germination.
Among the conditions favorable to the multiplication of the malarial ferment contained in the soil, and to its dispersion through the superjacent atmosphere, there are three which are absolutely essential, and the concurrence of which is indispensable for the production of bad air (malaria). First, a temperature which does not fall below 20°C. (67.5°F.); next, a very moderate degree of permanent humidity of the soil; and finally, the direct action of the oxygen of the air upon the strata of earth which contain the ferment. If a single one of these three conditions be wanting, the development of malaria becomes impossible. This is a point of prime importance in the natural history of malaria, and it gives us the key to most of the methods of sanitary improvement attempted by man.
Let us see first what can be done in this direction without the labor of man. For nature herself makes localities salubrious by suspending for a greater or less time the production of malaria. It is thus that winter brings about in every country a freedom from malaria which is purely thermic, for it is due simply and entirely to a sinking of the temperature below the required minimum. Indeed, if the temperature in winter rises above this minimum, there are often sudden outbreaks of malaria. Sometimes, during very warm and dry summers, the heat extracts all the humidity from the malarious soil, and thus procures for us a freedom from the disease which is purely hydraulic. This may continue for a long time (as happened in the Roman Campagna during the years 1881 and 1882), but may also be completely destroyed by a single shower. Nature also sometimes renders a district healthy in a manner purely atmospheric, by covering a malarious soil with earth which does not contain the malarial ferment, or with a matting formed of earth and the roots of grasses growing closely together in a natural meadow.
In the attempts of purification by suspending the malarial action, which have been devised by man, the same thing has been done; that is to say, it has been sought, to eliminate at least one of the three conditions essential to the development of the specific ferment contained in the infected soil. Naturally, they have not thought of bringing about a thermic purification, such as nature produces in winter, because of the impossibility of moderating the action of the sun; but they have tried from all time to procure hydraulic or atmospheric purifications, and sometimes to combine these together in a very happy way.
The hydraulic systems are very numerous, for the problem which is presented, namely, that of depriving the ground of its humidity during the hot season, necessitates different solutions according to the nature and the bearing of the soil. Sometimes this is done by digging open or closing ditches intended to draw away large bodies of water. At other limes a system of drainage is established, by means of which the water is drawn out of the earth and its level is depressed, so that the upper malarious strata, exposed to the direct action of the air, are deprived of moisture during the hot season. This system of drainage is not a modern invention; the Italian monks understood it as well as, and even better than, we do. In deep and loose soils they used sometimes, just as we do now, porous clay pipes; but when the subsoil was formed of compact and nearly impermeable matters, they employed a system of drainage, the extent and grandeur of which astonishes us. It is that of drainage by cavities, applied by the Etruscans, Latins, and Volsci to all the Roman hills formed of volcanic tufa, the tradition of which I have found still preserved in some countries of the Abruzzi.