12 



2. Yellow-fever hospital. 



This brings us to the second prophylactic measure advocated 

 above — the advantage, and indeed necessity, of a yellow-fever hos- 

 pital in dealing successfully with an epidemic. 



There is a prejudice among the people against the term " yellow- 

 fever hospital," hence it would be as well to yield to this prejudice 

 and call it an " isolation " or " observation " hospital. The important 

 point is that this hospital be absolutely mosquito proof, and that it 

 be made attractive, be clean and well managed, so that the people 

 may be drawn to it and feel that they will be as well or better 

 cared for in the hospital as in their own homes. The greater the 

 number of fever patients that can be removed to the hospital the 

 easier will be the task of stamping out the disease. 



Such cases as in the opinion of the sanitary officer can not be prop- 

 erly screened in their homes should be compelled to go to the hospital. 

 The transfer of the patient must be accomplished with such pre- 

 cautions as will prevent the possibility of his being bitten by a mos- 

 quito — under a mosquito-bar or in a screened ambulance. 



3. Martial law. 



To make the inspection thorough and effective and to compel the 

 transfer of the sick to the hospital when necessary, authority is re- 

 quired. In a republican form of government this authority is usually 

 wanting and these measures have to be carried out inefficiently and 

 in the face of great opposition. 



To obviate this the writer would advocate that martial law be de- 

 clared in epidemics when the conditions are such as to warrant it. 

 This legal procedure is frequently invoked when the menace to life 

 and property is not nearly so great as in an outbreak of yellow fever 

 or other infectious or contagious disease. 



With martial law to support the sanitary officer the prophylactic 

 measures herein advocated could be enforced in every detail and an 

 outbreak of yellow fever effectually controlled. It is easy to under- 

 stand why this agent was not invoked prior to the demonstration 

 of the transmitting factor of yellow fever, when our efforts to control 

 the disease were rather vague and uncertain; but to-day, when our 

 system may be made so precise and certain it seems almost criminal 

 not to take advantage of such a powerful auxiliary. 



In our epidemics the sanitarian, unsupported by authority, is 

 obliged to lose much precious time and energy in his efforts to gain 

 the good graces and plaudits of the populace, so that he may be per- 

 mitted to perform his work untrammeled. 



