HOUSE INSPECllNG 191 



the 'fifties, a mortality so great that to-day we cannot 

 realise it. In those days the West Indies were regarded 

 as the home of yellow fever, the islands where it was 

 endemic. The adjacent American Continent regarded 

 the islands as the source of all their epidemics. AVhen 

 discussing the march of general sanitation we showed 

 how both the yellow fever and malaria abated before 

 the modern weapons of drainage and water supplies. 

 Abated, however, only to a certain degree, just as in 

 Rio and in many other parts of the world. The really 

 significant change did not occur until the newest 

 weapons of medical science were unerringly directed 

 against the specific enemies — the stegomyia in the case 

 of yellow fever and the anophelines in the case of 

 malaria. Then, and only then, were these diseases 

 brought under absolute control. 



I wish in this narrative to state what those islands 

 which 1 have already visited have accomplished : how 

 far their methods are modern, whether they are still 

 hampered by prejudice and tradition, or are willing to 

 embrace the modern method. 



In the first place I will begin by giving my methods 

 of procedure when I arrive in a colony. 



1. I establish an office or headquarters, or secre- 

 tarial department, where the plan of campaign is drawn 

 up with the assistance of the local medical and health 

 authorities. 



2. The mornings are devoted to a house-to-house 

 examination of the locality in order to determine 

 precisely the number of breeding places of the 

 stegomyia, in the case of yellow fever. I invariably 



