EARLY NOTIFICATION 141 



one or more of the Government medical officers of any 

 colony to be sent, as occasion arises, to study any 

 particular disease affecting the prosperity of the colony, 

 to some place where the particular disease is common. 

 Tliis is one of the chief reasons why the medical officers 

 of the Marine Hospital Service are of such practical 

 service to the United States. 



Of supreme importance also is the necessity of 

 obtaining a post-mortem examination of the first 

 suspicious death. The post-mortem findings are cliar- 

 acteristic, and do not need microscopic confirmation. 



The notification of yellow fever is rightly regarded 

 as a very serious matter, and a young practitioner will 

 undoubtedly hesitate before he declares. If he has 

 notified, and the case does not turn out to be yellow 

 fever as he supposed, he regards his diagnostic power 

 as open to criticism, both by other doctors and by the 

 patient. If he is dealing with a genuine case, and 

 he hesitates till too late, no fumigation is undertaken 

 to kill the infected mosquitos at the outset, and in the 

 meantime contagion is spread — to make itself felt some 

 twelve days afterwards in the same house or in the 

 vicinity. The situation is unquestionably difficult, and 

 it can only be got over by fricndhj inter-reliance 

 amongst the medical men themselves, and by the 

 encouragement given by the Senior Medical Officer to 

 his juniors not to hesitate to express their difficulties 

 to him nor to think that thereby they suffer in his 

 estimation as careful observers. I am convinced that 

 this is very necessary, as there is evidence that this 

 spirit is not always present. 



