GORGAS — NOBLE. 621 



Gorgas's success in converting the Canal Zone and the cities of Pan- 

 ama and Colon into a region where the death rate was comparable 

 to that of our healthiest cities that sanitarians came from all over 

 the world to see and learn, and return to their homes with valuable 

 data and new ideas. So impressive were his results that he received 

 many invitations to advise corporations and countries on matters 

 of health and sanitation. Two were accepted. The first was an 

 invitation from the President of Equador to study the health condi- 

 tions of Guayaquil and submit outline plans for the sanitary re- 

 construction of that city, the principal seaport of the Republic. 

 Almost two months were spent in Equador, during which time ten- 

 tative plans were prepared and recommendations submitted. The 

 plans provided for adequate water supply, sewer system, paving the 

 streets, modification of health laws, and the revision of building regu- 

 lations, with especial reference to " rat proofing." His general plan 

 was adopted and much work has been done. Guayaquil has for 

 almost two years been free from yellow fever, and malaria incidence 

 has been much reduced. At the time of General Gorgas's visit to 

 Equador the death rate for Guayaquil was such that the city of 

 almost 90,000 people must be repopulated each 15 years or cease to 

 exist. The result of his visit is that one of the most unhealthy cities 

 of the world is now a city with a death rate comparable to that of 

 other tropical cities of the same size. 



In the summer of 1913 Mr. Samuel Evans, chairman of the Cham- 

 ber of Mines, Johannesburg, Transvaal, visited the Canal Zone to 

 make inquiry in regard to the housing conditions of the laborers and 

 the methods used for the control of pneumonia, a disease at one time 

 epidemic among employees of the Panama Canal. The control of 

 pneumonia was a matter of great importance to the mine owners 

 of South Africa, as the native laborer was very susceptible to that 

 disease, especially the tropical native. Among this class of laborers 

 pneumonia was very fatal; in fact, so high had been the death" rate 

 from this cause that the bureau of native affairs had prohibited the 

 employment in the mines of natives from tropical Africa. This 

 closed a source that supplied each year about 20,000 laborers. A 

 further restriction of recruiting areas was possible if the incidence 

 of pneumonia could not be lowered. This was a very serious mat- 

 ter, for the mines required over 200,000 laborers on the rolls to keep 

 up the average output. As a result of Mr. Evans's visit to the Canal 

 Zone, the Chamber of Mines invited General Gorgas to visit the Rand 

 and investigate conditions with the view of applying the methods 

 that had been so successful on the Canal Zone. The invitation was 

 accepted. General Gorgas sailed from Colon early in October, 1913, 

 for South Africa, and arrived at Johannesburg in November. A pre- 

 liminary survey of conditions was made. It was soon found that 



