Abstract

The Netherlands has always been ill-famed as a country with dangerous fevers, but intermittent fevers also occurred in other countries bordering the North and East Seas during the 19th and early 20th century. After the discovery that these fevers are caused by a protozoon, it took more than a decade before the microscope began to be used for the diagnosis of malaria. Disbelief, the low level of endemic malaria and the lack of a good staining method caused the tardy acceptance of the discoveries. A few descriptions of endemic tertian, quartan and imported tropical malaria were published, including a correct relationship with the appropriate parasite stages. Just after Ross's discovery of the role of mosquitoes, a new epidemic started and a few local physicians studied the epidemiology and transmission of tertian malaria. The general biology became known by 1900 and Anopheles maculipennis was found to be the vector. Dr. Schoo introduced screen protection of houses after a visit to Celli in Italy and his book on malaria in North-Holland served as a standard for the next 25 years. P.C. Korteweg analysed his clinical, therapeutic and prophylactic data and found that after withdrawal of long-term quinine regimes a wave of relapses occurred. He also suggested that a shift had occurred in the prevalence of P. malariae and P. vivax; the former almost disappeared before the turn of the century. The regional and epidemic character of Dutch malaria excited the interest of scientists and public health organisms only at the following epidemic in 1920