First Sanitary Work 275 



who were violating the ordinance to the fact that 

 they would be liable to prosecution, in accord- 

 ance with the ordinance; and in every way 

 possible, a strong effort was made to obtain the 

 people's support. 



•Subsequent inspection showing many delin- 

 quents, their names and addresses were forwarded 

 to the mayor of the city, who had authority to 

 impose fines. Practically no fines were imposed, 

 and the people of the lower class, finding the ordi- 

 nance not insisted on by the mayor, gave it little 

 attention. Each week a list of citizens violating 

 the ordinance during that week was duly for- 

 warded to the mayor. It is not known if any na- 

 tives were fined although rumor had it that some 

 foreigners were. 



The number of American employees and foreign 

 population increased as time passed. Every 

 means was used to induce the Mayor to enforce 

 the law, and render the work effective, but without 

 result. 



The first case of yellow fever occurred at the San 

 Tomas Hospital on November 21, 1904. The 

 patient was an Italian, and came from a restau- 

 rant at Santa Ana Plaza, near the center of the 

 town. The case was at once isolated in the mos- 

 quito-proof ward of the hospital. During De- 



