LIST OF ILLUSTRATIONS
| FACING | |
| PAGE | |
| Concreted Ditch. Ancon | Frontispiece |
| Map of the Panama Canal Zone, Showing Hospitals of the Sanitary Department | [1] |
| Stegomyia Squad. Havana | [52] |
| Screened Water Barrel. Havana | [52] |
| Concreted Ditch. Gatun | [112] |
| Screened Yellow-fever Ward. Ancon Hospital, Panama | [150] |
| St. Charles Ward, Ancon Hospital. Building in Which Twelve Hundred Frenchmen Died of Yellow Fever | [150] |
| Oilers at Work in Marsh | [184] |
| Burning Out Ditch with Oil Spray | [184] |
| Old French Engine Tender Used as Storage Tank for Oil | [194] |
| Mule for Packing Oil to Oilers | [194] |
| Distilled Water Cart. Culebra | [220] |
| Ward at Ancon Hospital | [220] |
| Stoned Ditch near Tivoli Hotel. Ancon, Panama | [234] |
| Bad Anopheles Breeding-ground on Artificial Fill. La Boca | [234] |
Map of the Panama Canal Zone, Showing Hospitals of the Sanitary Department.
SANITATION
IN PANAMA
CHAPTER I
YELLOW FEVER AND THE DISCOVERIES OF ITS TRANSMISSION
Yellow fever for two hundred years before the Spanish-American War caused great loss of life and much destruction of wealth. Every few years portions of the United States would become infected with this disease. In the earlier part of this period the disease was more or less local. As the Mississippi valley became more thickly populated, the extent of the disease and the injury caused became very much augmented. The epidemic of 1878 was probably the deadliest and most extensive epidemic of yellow fever which ever affected the United States. In this epidemic over thirteen thousand people in the Mississippi valley alone lost their lives, and the loss of wealth is estimated at considerably more than one hundred millions of dollars.
It is very difficult to convey to a reader any idea of the conditions which exist during an epidemic of yellow fever. All business is entirely paralyzed, the quarantines not allowing any communication between the affected districts and those not affected. In an epidemic of any extent this means hundreds of local quarantines. Some idea of the condition of affairs can be obtained by picturing what would occur in any community if all the income of that community should entirely cease for six months. And this was the condition of business all over the Mississippi valley every time yellow fever gained entrance.
The population originally feared yellow fever on account of the poverty, suffering and business depression always caused by the quarantines which had to be enforced to prevent its spread, and in time people came to associate this idea of dread with yellow fever itself. When this disease was announced in a town, everybody left who could. The sick were frequently left without care, and often a great deal of cruelty and cowardice was shown. If a person escaped from an infected region and became sick with the disease, or sick from any other cause, he was generally treated as if he were a leper, and would often be left to starve or die on the roadside.
It requires continuously warm weather for the yellow-fever mosquito to breed in sufficient numbers to propagate yellow fever; therefore, this disease never became endemic in the United States. I mean by endemic, existing all the year round and over a number of years. The frosts of winter, wherever they occur, either destroy all the yellow-fever mosquitoes, or reduce their number below the point at which yellow fever could be propagated.