YELLOW FEVER PROPHYLAXIS IN NEW ORLEANS 17 



It is, however, of the greatest importance to note, both in con- 

 nection with international sanitary rules and with the repeated and 

 most recent pronouncements from Washington upon the absolute 

 necessity of early notification, that on July 12th information had 

 already been conveyed to the Health Authorities (both State and 

 Municipal) by two medical men, of the existence of two very suspi- 

 cious cases of fever. Dr. Kohnke, the Corporation Medical Officer, 

 immediately investigated the situation, and stated that several days' 

 investigation in the Italian quarters, where the suspected cases came 

 from, " disclosed the presence of infection extending in spots 

 apparently over an area of about five squares ; the history of infection 

 dating back several weeks, the character of the disease not being 

 recognised by patients, and attending physicians." During this 

 investigation the Medical Officer gave instructions for fumigation, 

 and upon July 15th communicated the results of his observations to 

 the State Board of Health, describing the prophylactic measures 

 which he had set on foot, and requesting financial aid. As the result 

 of his appeal he was supplied with funds, and orders were issued to 

 commence the more systematic oiling of the cisterns. This was the 

 first step at prophylaxis, but it was local and incomplete. 



It is obvious, therefore, that by July 12th the disease had a firm 

 hold of the Italian quarter, that it might well have been present in 

 May, or early in June, and that when the official announcement was 

 made on the 22nd of July of the presence of Yellow Fever, there were, 

 in all probability, a very large number of cases in the City. Indeed, 

 it has been .officially estimated that about 100 cases of sickness 

 occurred in the infected quarter prior to July 21st, a large number of 

 which were probably Yellow Fever, and that some 20 deaths took 

 place, of which many were doubtless from Yellow Fever. 



In the interval between the 12th and the 22nd suspicion began to 

 be generally aroused, that an outbreak of Yellow Fever was 

 developing in New Orleans. Evidence of this is furnished by the 

 fact that the President of the Medical Society, Dr. Le Bceuf, urged 

 upon the Health Authority, on behalf of the Medical Profession, as 

 early as the 15th the imperative necessity of immediate and 

 stringent precautions. 



