372 



SCIENCE. 



[N.iS. V0L.XXIIL No. 584. 



2. I have no desire to underrate the work 

 done in Havana. It was a noble accom- 

 plishment, and one that should immortalize 

 its doers, but we must remember that the 

 Cuban city had a population ninety-five 

 per cent, of whom were immune, and was 

 built upon high and dry ground, while the 

 population of New Orleans was at least 

 seventy-five per cent, non-immune, the city 

 itself being a perfectly natural habitat for 

 the mosquito. 



The fight began in Havana in the early 

 spring, against two or three cases. It be- 

 gan in New Orleans under the blazing sun 

 of late July, and against hundreds of eases. 



3. There were two distinct organizations 

 in the city of New Orleans, each one having 

 the same object in view and working in 

 cooperation with each other. The Citizens 

 Volunteer Ward Organizations sought to 

 destroy all mosquitoes by the screening and 

 oiling of cisterns, by the oiling of gutters 

 and pools, and a desultory sulphurization 

 of houses. This last they could only ac- 

 complish by pleading with the people to do 

 it, and nothing like perfection in this line 

 was ever attained at any time, the laissez 

 faire of the attitude of the people in gen- 

 eral upon this question being too well 

 known to need comment. 



4. The regular organization consisted of 

 a central headquarters, with, at first, six- 

 teen, and subsequently eighteen, ward 

 headquarters, corresponding, practically, 

 with the political geography of the city. 

 Each of these subheadquarters was in com- 

 mand of a medical officer, provided with 

 from one to six medical assistants, accord- 

 ing to the needs of his station, and kept 

 in touch with the central office through the 

 medium of an officer who served as adju- 

 tant. Each subdivision had its own gangs 

 of inspectors, screeners and fumigators, 

 and was furnished with all necesary sup- 

 plies from a purveying depot established 

 for that purpose. 



5. Upon the report of a case of fever, 

 either suspicious or yellow, to the city 

 board of health, the central headquarters 

 or the ward headquarters, the information 

 was immediately conveyed to the command- 

 ing officer of the ward concerned, and a 

 screening gang at once started for the 

 house, placing screens and, if need be, 

 mosquito bars around the patient, who, if 

 his condition permitted it, was moved into 

 another room, his own room fumigated and 

 he then returned thereto, the rest of the 

 house being at once fumigated. All cracks 

 were pasted over from the inside and all 

 chimneys attended to at the earliest possible . 

 moment in order to prevent their becoming 

 the hiding-place of the infected Stegomyia. 

 Before the expiration of twelve days, a 

 second fumigation was resorted to in order 

 to be sure that no infected mosquitoes es- 

 caped. 



6. Our work with its results fully justi- 

 fies the assertion made by Dr. Carroll, that 

 the best policy is to treat all cases of fever 

 as worthy of suspicion. There is no doubt 

 that during this fight there were thousands 

 of unnecessary disinfections done, but it 

 was just as necessary as any other part of ■ 

 the work, as long as no man can always be 

 relied upon to make an exact diagnosis in 

 any disease, the causative entity of which 

 is not definitely known, hence we did not 

 wait for definite diagnosis, but disinfected 

 first and secured the diagnosis when we 

 could. 



7. Of course any sick persons willing to 

 go there were removed to the emergency 

 hospital provided for the purpose, and so 

 carefully screened and safeguarded against 

 mosquitoes in every way as to render the 

 use of mosquito bars unnecessary. 



In the original infected area house-to- 

 house inspection, and, indeed, house-to- 

 house disinfection, v/ere kept up continu- 

 ously from the latter part of July until 

 about the first of October. All over the 



