CHAPTER II 



THE SITUATION ON THE ISTHMUS BEFORE SANITARY 

 WORK WAS STARTED 



IN his Report on the Isthmian Canal, 1904, 

 Colonel Gorgas stated: 



In my opinion the sanitary problems are grave. 

 The question of eliminating yellow fever from an 

 endemic focus has only been once before successfully 

 managed, and that was at Havana. And from this 

 successful work, to argue that it is easy and simple, I 

 think is not warranted. The malarial work on the 

 scale at Panama is entirely new. It has never been 

 attempted elsewhere, and any health officer who has 

 any experience in enforcing measures of individual 

 prophylaxis such as will be required at Panama, can 

 understand how great the difficulties of administration 

 will be. Personally, I believe it can be done, and I 

 approach the work with great hope of success, but I 

 know that it will be neither easy nor simple, that we 

 will meet with many disappointments, and have to 

 modify our plans many times. 



YELLOW FEVER 



From the knowledge gained in the anti-yellow 

 fever campaign in Havana, Colonel Gorgas rightly 



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