On June 20, 1905, Nehemiah Morgan, a Jamaican negro, employed at La Boca, the southern terminus of the Canal, was admitted to the hospital with symptoms of bubonic plague. The name La Boca has since been changed to Balboa. This man died on June 23, and the autopsy confirmed the diagnosis. On the twenty-sixth, a quarantine was placed against La Boca. Dr. James Perry, of the United States Public Health Service, was placed in charge. He was supplied with a force of four foremen and one hundred laborers, who under his direction did the necessary cleaning and fumigation. This quarantine was kept up until July 15, when it was raised, as there was no further indication of plague or plague-infected rats.

Dr. Perry deserves the greatest credit for the efficient way in which he managed to stamp out this infection, so threatening and dangerous to the work.

Plague is an infectious disease caused by a well-known germ, the bacillus pestis. It is a disease of the rat, and is transferred from the rat to a human being by the rat flea. Anti-plague measures are, therefore, almost entirely directed toward the destruction of rats. Rigid quarantines are also kept up, so as to prevent human beings sick with the disease from going to uninfected places, and there starting new foci of infection.

The measures used against rats are poisons of various kinds, but the rat is one of the most intelligent of animals, and soon learns to avoid poisons. The same thing is true with regard to traps. Rats so rapidly learn about poisons and traps that some writers on anti-plague measures advise that these measures be used only during emergencies, when plague is either present, or there is imminent danger of an outbreak, the argument being that if you use these measures continuously, the rats will become so knowing that you cannot kill them when plague is upon you and they are actually infected.

Mr. Le Prince arranged a very successful rat-trap which killed the rat by short-circuiting between two electric wires. Such a trap placed in a rat runway gave no notice to the rat whatever, and always killed him. But it requires some skill to manipulate such a trap, and our Jamaican darkies were so often shocked in trying to arrange it that Mr. Le Prince gave it up.

Undoubtedly, the best anti-plague measures are those calculated to free the town from rats permanently, and these measures relate principally to rat-proofing the houses. In a general way, these measures consist in making a concrete floor, and in putting six or eight inches of concrete in the wall around this floor. With the whole town fixed up in this way, you would have no rats. At the same time, disposal of garbage should be carefully looked after, with the object of limiting the food supply of rats.

Dr. Connor, of Colon, invented an excellent garbage stand, so arranged that a lid automatically closed the garbage can whenever the lid had been raised and released. If, however, a town has been made entirely rat-proof, that town is pretty secure from plague. If there are no rats there, no harm will be done, even if cases of plague come in, for there would be no means of transmitting it from man to man. If you have plenty of rats in a commercial city, such as Panama, in direct commercial relation with cities having plague, you are sure, in the course of time, to get in plague cases, no matter how good your quarantine, and if plague once gets in where there are plenty of rats it is very apt to spread.

CHAPTER XXII
THE WORK OF THE SANITARY DEPARTMENT OF PANAMA

The work of the Sanitary Department of Panama has without question been a most useful adjunct in the construction of the Canal. It has enabled this work to be carried through with a minimum of loss, both in regard to sickness and death among employees engaged in construction work in the Canal Zone. We have no means of telling what was the sick rate with the French during the period of construction under the old French Company, from 1881 to 1889, but we know that it was very large.

Our Army in Cuba during the Santiago campaign had during the last two months of our stay there a constant sick rate of over six hundred per thousand. Undoubtedly, the French rate approximated this during their period of active work, and we can safely calculate that their constant sick rate was at least three hundred and thirty-three per thousand, or one-third their force.