WALTER REED. 267 



by the bite of the previously infected Stegomyia. Articles used and 

 soiled by patients do not carry infection. 



These conclusions pointed so clearly to the practical method of 

 exterminating the disease that they were at once accepted by the sani- 

 tary authorities in Cuba, and put to the test in Havana, where for 

 nearly a cenury and a half, by actual record, the disease had never 

 failed to appear annually. In February, 1901, the chief sanitary 

 officer in Havana, Major W. C. Gorgas, Medical Department, U. S. 

 Army, instituted measures to eradicate the disease, based entirely on 

 the conclusions of the commission. Cases of yellow fever were required 

 to be reported as promptly as possible, the patient was at first rigidly 

 isolated, and immediately upon the report a force of men from the 

 sanitary department visited the house. All the rooms of the building 

 and of the neighboring houses were sealed and fumigated to destroy 

 the mosquitoes present. Window and door screens were put up, and 

 after the death or recovery of the patient, his room was fumigated and 

 every mosquito destroyed. A war of extermination was also waged 

 against mosquitoes in general, and an energetic effort was made to 

 diminish the number bred by draining standing water, screening tanks 

 and vessels, using petroleum on water that could not be drained, and in 

 the most systematic manner destroying the breeding places of the 

 insects. 



When the warm s< ason returned a few cases occurred, but by Sep- 

 tember, 1901, the last case of yellow fever originated in Havana, since 

 which time the city has been entirely exempt from the terrible disease, 

 that had there kept stronghold for a hundred and fifty years. Cases 

 are now admitted into Havana from Mexican ports, but are treated 

 under screens with perfect impunity, in the ordinary city hospitals. 

 The crusade against the insects also caused a very large decrease in 

 malarial fevers. 



The destruction of the most fatal epidemic disease of the western 

 hemisphere, in its favorite home city is but the beginning of the benefit 

 to mankind that may be expected to follow the work of Eeed and his 

 associates. There can be no manner of doubt should Mexico, Brazil 

 and the Central American Eepublics, where the disease still exists, 

 follow strictly the example set by Havana, that yellow fever will become 

 extinct and the United States forever freed from the scourge, that has 

 in the past slain thousands of our citizens and caused the loss of untold 

 treasure. 



More recent investigations into the cause and spread of yellow fever 

 have only succeeded in verifying the work of Eeed and his commission 

 in every particular and in adding very little to our knowledge of the 

 disease. Later researches by Guiteras in Havana, by the Public Health 

 and Marine and Hospital Service in Vera Cruz, and lastly by a delega- 

 tion from the Pasteur Institute of Paris in Eio de Janeiro, all confirm 

 in the most convincing manner, both the accuracy and comprehensive- 



