( i8 ) 
In my judgment, the simple provision which is necessary for the preservation 
of the Colony from those diseases which may shut it out from free intercourse 
with other countries has a greater claim on the administration than the local 
general hospitals intended for the reception of non-infectious diseases. 
The local isolation hospital should not be confounded with the isolation 
hospital necessary for the proper execution of quarantine, the local hospital is 
for the reception of infectious cases coming from the town or country districts. 
A site for a small isolation hospital on the outskirts of the town could, I feel sure, 
be readily found. 
3. — Isolation by Screening the Patient. 
Both with regard to the isolation of the patient and the application of 
fumigation there is a great want of precision. It is useless for anyone to 
apply these two cardinal preventive measures unless they understand the role 
of the mosquito in the dissemination of the disease. I he infected mosquitoes 
have to be destroyed both in the house of the patient and often in the 
adjoining blocks, and the patient must be so placed that no mosquitoes can 
gain access to him. Those who are familiar with the habits of mosquitoes 
know that it is not an easy task to bring about their thorough destruction in 
living houses, and that fumigation must be applied with absolute thoroughness 
to all parts of the house, closets and outhouses, and that to do this the house, 
closets and outhouses must be so completely sealed that a mosquito cannot get 
away through any chink. Again, those familiar with mosquitoes, know that it is 
very difficult to keep them out of screened rooms, unless the screening is well 
done and the doors are of the proper kind. It is only by the rigid application of 
these two methods that an epidemic can be stamped out quickly. In the hands 
of good men, experience has taught that both these measures can be applied 
with scientific precision. 
I recommend that both the screening' and fumigation in cases of fever be 
carried out under the direct supervision of the Medical Officer of Health and by 
his staff. 
The staff of the Medical Officer should, without delay, be instructed how to 
seal a room, how to fumigate, and how to test the efficiency of the fumigation. 
The methods at present in vogue for fumigating and disinfecting for diphtheria, 
scarlet fever, &c., will not do. 
A supply of the necessary materials for screening, including laths and frames, 
paper strips, fumigators and fumigating material should be kept in the Health 
Office for emergency purposes, and the Health Officer should know where he 
can immediately procure additional supplies. Simple rules for the guidance of 
the men should be drawn up. 
In my judgment, in view of the fact that mosquito-borne diseases cause more 
sickness and mortality in the Tropics than those arising from any other cause, it 
is not too much to expect that sanitary inspectors and others attached to Health 
Offices in the Tropics should be taught the precautions to take against them ; 
this is, however, frequently omitted, and instead they are taught principles of 
European sanitation, which are inadequate to deal with malaria or \ ellow fever. 
Screening the Patient and Room. — In either doubtful or well-marked cases 
the patient is to be at once placed under bars in charge of a nurse, and the room 
