280 A HISTORY OF NATIONAL TUBERCULOSIS ASSOCIATION 



the extraordinary progress, in certain lines of social endeavor during the last 

 two or three generations; and in no other manifestation of human activity 

 have the changes been quite so far reaching as in the ability to grapple with 

 disease. It is not so very long, measuring time by history, since the attitude of 

 man toward a disease such as that of consumption was one of helpless acquies- 

 cence in what he considered to be the mandates of a supernatural power. It 

 is but a short time since even the most gifted members of the medical profession 

 knew as little as any layman of the real causes of a disease like this, and there- 

 fore necessarily of the remedies to be invoked to overcome them. It is an affair 

 of decades, I am almost tempted to say an affair of years, when we go back 

 to cover the period in which the real progress has been made. Take, for in- 

 stance, the work the United States government is now doing in Panama. When 

 the first railroad was built across Panama, it was said, with some foundation of 

 truth, with but slight exaggeration, that 'every sleeper laid cost the life of a 

 man.' Now the work on the canal, in that identical place, is being prosecuted, 

 on an infinitely larger scale of course, than the mere building of a railroad, under 

 conditions which make the locality stand above the ordinary locality in the 

 United States in point of health. The Isthmus of Panama, which was a by- 

 word for fatal disease, has become well-nigh a sanatorium; and it has become 

 so because of the investigations of certain medical men which enabled them to 

 find out the real causes of certain diseases, especially yellow fever and malarial 

 fever, and to take measures to overcome them. The older doctors here, when 

 they were medical students, would have treated the suggestion of regarding 

 mosquitos as the prime source of disease like that as a subject for mirth. Is 

 not that literally true? These utterly unexpected results have followed patient, 

 laborious, dangerous, and extraordinarily skilful work that has enabled the 

 cause of the disease to be found and the diseases themselves to be combated 

 with extraordinary success. I said dangerous work. That success had its 

 martyrs; doctors laid down their lives to secure the results of which I have 

 spoken, showing exactly as much heroism as ever was shown by the soldier 

 on the field of battle. 



"At this moment, in the middle of the great continent of Africa, there is a 

 peculiarly fatal and terrible disease the sleeping sickness; a disease which, 

 if it had been known to our ancestors in the middle ages, would have been 

 spoken of as the black death was spoken of in the middle ages as a scourge 

 sent of God, possibly as something connected with a comet, or some similar 

 explanation would have been advanced. We know now that it is due to the 

 carrying of a small and deadly blood parasite by a species of biting fly, there 

 being this very curious genus of biting flies in Africa, one form of which, al- 

 though harmless to wild animals and men, conveys by its bite a fatal infection 

 to all domestic animals, and even to the closest allies of the wild animals, to 

 which its bite is fatal; while the other form, which does not seem to be fatal 

 to domestic or wild animals, is responsible for the spread of this terrible disease, 

 the sleeping sickness, which in one region killed two hundred thousand out of 

 three hundred thousand inhabitants a rate of slaughter, of course, infinitely 

 surpassing that of any modern war. And the chance to control that disease 



