The Panama Canal

imate and health conditions at the isthmus. It is fairly certain that yellow fever and malaria would have wrecked the French undertaking even if there had been no other obstacles to

the individual victim when they found him and do their best to cure him. They still believed that malaria was produced by climatic conditions, by marshy emanations, mists, and so forth. The fleecy clouds which gather round the isthmian hills in the rainy season were given the very undeserved title of "the white death" by the French wo

isease by the anopheles mosquito belongs to Major (now Sir) Ronald Ross, formerly of the Indian Medical Service, who devoted himself to this subject during the last years of the 19th century. By a series of experiments he proved that malaria is due to the presence in the human blood of an organism which is conveyed from person to person by this mosquito, and that the mosquito is harmless unless it has become infected with the germ by biting a person who has caught malaria. The value of this discov

occurred among the troops occupying Havana, in Cuba. The doctors were quite unable to deal with this most terrible of all diseases. Knowing nothing whatever of its cause, their treatment of it could be only experimental and casual. So a board of inquiry was formed consisting of four army surgeons serving in Cuba-Walter Reed, James Car

s, but it was still uncertain how soon after biting an infected person the mosquito becomes itself harmful and how soon a person stricken with malaria is able to infect a healthy mosquito. So further experiments were necessary, and volunteers were invited to offer themselves for this service. Everybody in the army knew what had happened to Doctors Carroll and Lazear, but in spite of this plenty of willing martyrs appeared. The first to present themselves were two young soldiers from Ohio, John R. Kissinger and John J. Moran. Dr. Reed talked the matter over with them, explaining fully

's entrance he was being bitten about the face and hands by the insects, that had promptly settled down upon him. Seven, in all, bit him at this visit. At 4.30 p.m. the same day, he again entered and remained twenty minutes, during which time five others bit him. The following day, at 4.30

nd into this was stored a large amount of bedding and clothes which had been used and worn by persons suffering from the fever. The building was carefully guarded against the intrusion of mosquitoes, and a temperature of seventy-six degrees, with a sufficient moisture, maintained. For twenty consecutive days Dr. Clarke and hi

Dr. Lazear who sacrificed his life and the many others who cheerfully risked their lives to establish truths and fa

are not yet fully ascertained. The stegomyia is said to live three months. Dr. Cornish states that it becomes dangerous only by attacking man during the first three days of yellow fever, and that, even then, twelve days elapse before its bite is infectious. Six days after a man has been bitten by an infected stegomyia he falls ill with yellow fever, and for the next three days he is capable of transmitting it to the healthy mosquito. Mr. Bishop informs us that if there is no fresh case of yellow fever within a period of sixty days after th

ease, but he remains infectious to the anopheles for three years. The disease does not simply attack new-comers or white people. Natives of the isthmus and the West Indies are subject to it, and, indeed, seem to be in a chronically malarious condition. It is sai

ject, made some interesting remarks in an address at the

I was struck with the impossibility of conceiving that the people who are now intensely afflicted with malaria could be like the ancient Greeks who did so much for the world; and I therefore suggested the hypothesis that malaria could only have entered Greece at about the time of the great Persian wars. One can scarcely imagine that the physically fine race and the magnificent athletes figured in Greek sculpture could ever have spent a malarious and splenomegalous childhood. And, conversely, it is difficult to imagine that many of the malarious natives in the tropics wil

stressing malady. The reader will notice that, as the yellow fever victim is only infectious to the mosquito for three days, while the malarial person can convey the poison for three years, it is a much more practical problem to eradicate yellow fever than to stamp out malaria. It is true the causes of malaria are now fully known and the only effective methods of propagation ascertained. If one could isolate all malarial patients, including all who are capable of transmitting the disease

rtment. "The experience of our predecessors," he wrote, "was ample to convince us that unless we could protect our force against yellow fever and malaria we would be unable to accomplish the work."[10] When the Americans took over, yellow fever, though present, was quiescent, but the figures began almost at once to mount up. In December 1904 there were six cases on the isthmus and one death. In January 1905 there were nineteen cases and eight deaths, seven and one respectively among the canal employees. In May there were thi

States, while those who remained became possessed with a feeling of lethargy or fatalism, resulting from a conviction that no remedy existed f

bitions at the isthmus. The restoration of public confidence and sense of responsibility seems to have been due largely to Mr. Charles E. Magoon, governor of the canal zone. He set himself to rebuke and remove the morbid bravado then prevailing. "He began by frankly and publicly declaring that he, personally, was afraid of the fever, and that in his opinion all non-immunes who professed not to be afraid were 'talking rot!' Then he ordered all the window

st--Washi

lliam C

y, Head of the Departme

the hospital or their own homes, so that no stegomyia mosquitoes could saunter in and take the poison. Then the towns of Colon and Panama were handed over to a campaign of spring-cleaning such as the world has never witnessed. Then the canal building was thoroughly fumigated with pyrethrum powder or sulphur, an

towns, and a supply of pure water made available for every household. Hitherto water had had to be stored during the dry season in tanks and cisterns, in which the stegomyia mosquito revelled exceedingly. These were now no longer necessary, and stagnant water, wherever it collected in the town, was d

on the canal. The improvement continued through September, October, November, and in December only one case was reported on the isthmus and one on the canal. Three months having elapsed since the last case, and, therefore, every stegomyia which could possibly be infected with malaria having departed this life, the epidemic was entirely past and over. As I have p

of a million acres of that territory, but wherever the canal workers were settled determined war was waged against the mosquitoes. It should be remembered that the anopheles can fly only about a hundred or two hundred yards. The jungle was therefore cleared away for a few hundred yards round each village and settlement, marshes and pools in this area were drained off

sanitation of the country in this respect, for the simple reason that the destruction of the anopheles mosquito or the eradication of the malarial germ can never be complete. There will always be people going about with the malarial organism in their blood, and always anopheles mosquitoes ready to become infected with it and to carry the infection about. But, as we have seen, much can be done by

total, 4,119 died of disease and 1,022 from violence or accident. During the same period 49 American women and 87 American children died.[12] Sir Ronald Ross, as I have said, was told by the British Consul at Panama in 1904 that the

that we get a grand total expenditure on sanitation of $18,000,000. This will certainly rise to $20,000,000 before the canal is finished, so that for the ten and a half years of its construction there will have been an annual expenditure for all health purposes of $1,900,000. It is not likely that there will be many tropical areas of this kind with so large a sum available for the luxury of scientific sanitation. Again, it must be noticed that the administration had special advantages at the isthmus. It exercised something like military authority. It had absolute powers of deportation, and co

nated life in the tropics for the Anglo-Saxon will be more healthful than in the temperate zones; that gradually, within the next two or three centuries, tropical countries, which offer a much greater return for man's labour than do the

ur, in equatorial regions as in his native temperate conditions, or that his descendants will also maintain the same standard of

TNO

s." Mr. J. B. Bishop in Scrib

Monthly, Februa

can Medical Associ

turies of the

's Magazine, Febr