HEALTH, NATIONAL BOARD OF. 



sand slaves were entered in 1768. In 1774 

 th.ro were 75,180 blacks. Diligent inquiry 

 was made for some spot on the island exempt 

 from visitation. Reports from more than forty 

 towns prove that wherever there is food for it 

 in uiiacrlimated population, it prevails, though 

 with varying and erratic intensity. At Puerto 

 Principe, an inland and elevated city, hospital 

 records show its prevalence every year but one 

 since 1850. In Havana the fever is usually 

 epidemic from Juno to October, and endemic 

 during the rest of the year. From 1870 to 

 187!>, in no month have there been fewer than 

 4 deaths, nor more than 675. . During this de- 

 cade the minimum of deaths was 515 in 1872 ; 

 the maximum, 1,619 in 1876. From one fourth 

 to one half of these deaths occur in the mili- 

 tary hospital. This disproves the assertion 

 that yellow fever is specially severe in the 

 shipping and harbor. 



III. The causation of this endemicity. The 

 geography, geology, and meteorology have not 

 altered since 1761. Endemicity must be caused 

 by differing conditions. Previous to the Eng- 

 lish invasion in 17(52, Cuba had no commerce. 

 The introduction of steam navigation in 1819, 

 and of railroads in 1836, contributed to the 

 rapid spread of the disease. Spanish medical 

 authorities, official and unofficial, class yellow 

 fever among contagious diseases. Though 

 some may deny its contagiousness, none dis- 

 pute its portability and importability. Yet in 

 the military hospital, where yellow fever is 

 rarely absent, the lower story is used to store 

 blankets, clothing, and other hospital supplies 

 for general distribution over the island. The 

 paper currency of Cuba is noisome and filthy 

 to a degree. On October 4th clean bills of 

 health were furnished by Havana officials. 

 During that week there were eighty cases and 

 twenty deaths of yellow fever, and nine infected 

 vessels in the harbor. The Commission pro- 

 cured the meteorological records of Havana for 

 twenty years. The annual mean temperature 

 of the island varies from 77 to 79 F. The 

 only record of a frost is on the 24th and 25th 

 of December, 1856. The average rainfall is 

 about 50 inches; number of rainy days, 102. 

 Violent winds and hurricanes are injurious to 

 the sick, but they dilute the poison and lessen 

 the number of new cases. Investigations of 

 electricity, magnetism, and ozone have so far 

 yielded no satisfactory results. 



IV. The actual sanitary condition of Ha- 

 vana, Matanzas, and other Cuban ports. The 

 unsanitary condition of Cuba is demonstrated 

 by the death-rate. In different parts of the 

 island and in different years the annual mor- 

 tality varied from 89'5 to 67*05 per thousand. 

 Among destructive diseases yellow fever ranks 

 third. Phthisis stands foremost. This malady 

 makes frightful havoc among residents, yet 

 consumptives are still ordered to Havana. 

 Statistics confirm Bowditch's law concerning 

 the pernicious influence on consumption of 

 foul air combined with subsoil moisture. Under 



whatever name registered, swamp-poison or 

 malaria is the deadliest agent in Cuban mor- 

 tality. The water-supply flows, partly through 

 mi aqueduct, partly through a ditch, from the 

 Almandares River, four miles distant. Water 

 is scarce and costly. A large part of the popu- 

 lation purchase it from street venders. Per- 

 sonal and household cleanliness is renden <I 

 difficult. That part of the supply which comes 

 through the Zanga, an open earth-ditch, is im- 

 pure as well as inadequate. A half-finished 

 aqueduct, which has already cost $8,000,000, 

 may obviate this difficulty if it is carried to 

 completion. The sewerage is grossly defective. 

 The surface-soil is shallow. The substratum 

 rock is porous and friable, admitting a high 

 degree of saturation. A moisture-mark may 

 be observed high on walls of houses, even on 

 those built a hundred feet above the sea-level. 

 The water and soil being in such plight, the 

 air is necessarily foul. Ventilation in the old 

 town is obstructed. The streets are so narrow 

 that vehicles are only allowed to travel in one 

 direction. The paved streets of the modern 

 town are kept clean. Even there, however, 

 repulsive odors greet the nostrils, teaching the 

 presence of fecal and kitchen refuse reeking 

 within the courts of even the better class of 

 houses. These are usually built low. The 

 floors, of wood or brick, are on the ground, if 

 not below it. The interior arrangements are 

 unwholesome. Kitchens, cabinets, and stables 

 are close to sleeping apartments and intolerably 

 offensive. Buzzards resting on the root's show 

 the call of nature for scavengering. Mampos- 

 teria, or rubble masonry, is the ordinary build- 

 ing material. The walls testify to its porous 

 and absorbing qualities. Rents are high and 

 houses overcrowded. Since 1S06 burial in 

 churches has ceased. In 1871 the intramural 

 cemetery of Espada was closed upon its 800,000 

 dead. The new cemetery is well located, be- 

 yond the reach of evil influence. No abate- 

 ment of fever has been observed. 



The picturesque harbor of Havana suffers 

 under a bad reputation. English naval vessels 

 are forbidden to use the harbor-water for any 

 purpose. The anchorage-ground for large ves- 

 sels is contracted. An average of 100 vessels, 

 sometimes as many as 227, lie close to each 

 other and to the shore. It is the receptacle of 

 a vast surplus of filth. Very little clean water 

 finds its way into it. The tide has a rise and 

 fall of about two feet. The remarkable phos- 

 phorescence of its waters has been considered 

 connected with yellow fever. In 1879 the 

 fever made its appearance, and not the phos- 

 phorescence. On its southern edge lie five 

 piles of ballast. This ballast, whic-h freely 

 absorbs fluids and gases, should be treated as 

 dangerous yellow-fever fomites, at least until 

 this theory is disproved. Hygienic laws are 

 thus violated in all the Cuban ports, and that 

 where the conditions most favorable to yellow 

 fever exist, viz., hot climate and dense popula- 

 tion. 



