WOEK m PANAMA 431 



the covers would not have to be taken off in drawing water. Upon first inspec- 

 tion, in March, four thousand breeding-places were reported in Panama alone. 

 At the end of October less than four hundred receptacles containing larvae 

 were recorded ; this gives one a fair idea of the reduction in the number of mos- 

 quitoes in the city. These operations were directed primarily against the yellow- 

 fever mosquito, and involved the other species that inhabit rain-water barrels. 

 Against the Anopheles in the suburbs the same kind of work was done which was 

 done in Havana, with excellent results. 



The same operations were carried on in the villages between Panama and 

 Colon. There are some twenty of these villages of from five hundred to three 

 thousand inhabitants each. The result of the whole work has been the elimina- 

 tion of yellow fever, and the verj* great reduction of malaria. The remarkable 

 character of these results can only be Judged accurately by comparative methods. 

 It is well known that during the French occupation there was an enormous 

 mortality among the European employees and that this was a vital factor in the 

 failure of the work. Exact losses can not be estimated, since the work was done 

 under seventeen different contractors. These contractors were charged one 

 dollar a day for every sick man taken care of in the hospital of the Canal Com- 

 pany. Therefore it often happened that when a man became sick his employer 

 discharged him to avoid the expense of hospital charges. There was no police 

 patrol of the territory and many of these men died along the line. Colonel 

 Gorgas has stated that the English consul who was at the Isthmus during the 

 period of the French construction was inclined to think that more deaths of 

 employees occurred outside of the hospital than in it. A great many were found 

 to have died along the roadside while endeavoring to reach the city of Panama. 

 The old superintendent of the French hospital stated that in one day three of 

 the medical staff died from yellow fever, and in the same month nine of the 

 medical staff. Thirty-six Catholic sisters were brought over as female nurses, 

 and twenty-four died of yellow fever. On one vessel eighteen young French 

 engineers came over, and in a month after their arrival all but one had died. 



With the mosquito relation well understood, not a single case of yellow fever 

 was contracted during the first two years under Doctor Gorgas, although there 

 were constantly one or more yellow-fever cases in the hospital, and although 

 the nurses and doctors were all non-immunes. The nurses never seemed to 

 consider that they were running any risk in attending yellow-fever cases night 

 and day in screened wards, and the wives and families of officers connected with 

 the hospital lived about the grounds knowing that yellow fever was constantly 

 being brought into the grounds and treated in nearby buildings. Americans, 

 sick from any cause, had no fear of being treated in the bed immediately ad- 

 joining that of a yellow-fever patient. Colonel Gorgas and Doctor Carter lived 

 in the old ward used by the French for their officers, and Colonel Gorgas thinks 

 it safe to say that more men had died from yellow fever in that building than in 

 any other building of the same capacity at present standing. He and Doctor 

 Carter had their wives and children with them, which would fonnerly have been 

 considered the height of recklessness, but they looked upon themselves, under 



