4 YELLOW FEVER PROPHYLAXIS IN XEW ORLEANS 



the place. The poorer unassimilated members of this imported 

 population are suspicious and very averse to seeking medical aid, 

 and cases of Yellow Fever occurring amongst them might never have 

 been brought to the notice of the Health Authorities. The district 

 in the neighbourhood of the French Market where they chiefly con- 

 gregated, and known as " Little Italy," had become very dilapidated. 

 Human beings and animals were herded together in close proximity, 

 the court yards were littered up with rubbish, consisting of rotting 

 wood, tin cans, bottles, and disused tubs, which had been allowed to 

 accumulate during many years, owing equally to the very inadequate 

 sanitary supervision and the absence of a proper system of refuse 

 removal, no doubt also to the habits of the people. No proper 

 drainage existed in the yards, the closets were very dilapidated, and 

 were constructed on the cess pit or pail system. The whole neigh- 

 bourhood overcrowded, foreign, insanitary, and superstitious, consti- 

 tuted the most favourable nidus in the City for any infective process 

 to take deep root and spread, provided the Stegomyia was also present. 

 Moreover, every yard contained one or more large unprotected water 

 receptacles which gave rise to immense numbers of the Stegomyia 

 fasciata, which, after they emerged from the pupa stage immediately 

 sought refuge and blood in the overcrowded living rooms a few feet 

 distant. 



In the streets in the older part of the town the sanitation was 

 comparable to the condition of the houses. The paving of the roads 

 was exceedingly bad and irregular (fig. 2), and allowed of the forma- 

 tion of numerous pools after rain. An open drain on each side of the 

 roadway contained for the most part very slowly moving or stagnant 

 putrescent water. The sewage fungus, Sfhcerotilus nutans, and the 

 red worm {Chironomus) were prominent everywhere where there was 

 the least current. An abundance of solid decomposing refuse partially 

 blocked them up at frequent intervals. Every now and then drains 

 were " cleaned out " and the sludge was deposited on the roadway, 

 often to be allowed to remain on the street till it had been completely 

 scattered, or had found its way back to the drain again. The result 

 of the absence of a proper system of garbage and sewage disposal was 

 the production of an all-pervading odour of sewage, impossible to 

 dissipate in the close and intensely hot summer months. 



This condition of affairs contrasted remarkably with the better 



