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CHATTER II. 
PROPHYLACTIC MEASURES AGAINST YELLOW FEVER. 
In Junk, 1900, Army Surgeons Reed, Carroll, Lazear and Agramonte were 
sent to Cuba to study Yellow fever, and succeeded, by most exact and convincing 
experiments, to prove conclusively the role of the Stegomyia fascia/a in transmitting 
yellow fever. In the same year an expedition was sent from England to Para, an 
endemic focus of the disease in Brazil, and very shortly afterwards France and 
Germany followed with other scientific commissions. The Marine Hospital 
Service established early in 1902 a Yellow Fever Institute to study the oetiology 
and transmission of the disease, and sent out working parties to Vera Cruz and 
other places to obtain information on the spot. Mexico and Brazil have 
co-operated in these investigations, and most recently the Liverpool School of 
Tropical Medicine has, for a second time, established an observation laboratory 
at Para. A group of skilled workers has therefore been applied to the 
elucidation of this disease, with the result that the original experiments of Reed, 
Carroll, Agramonte and Lazear have been fully confirmed, and that the sole 
transmitter of the disease has been proved by repeated experiment to be the 
-Stegomyia fasciata. If an example were necessary of the devotion of these 
workers to the problems before them, it is furnished by the fact that a large 
proportion of them contracted the disease, and that several died. 
The result of the mass of exact scientific information which has been 
obtained by these investigators was soon made evident by those whose duty it 
is to take practical measures to eradicate Yellow fever. The first great applica- 
tion took place in Havana in 1901, and was carried out by Major Gorgas under 
the very efficient administration of General Wood. The result is well known, it 
was a great success. Since then similar methods have been employed in the 
United States, Mexico and South America, whilst this summer the opportunity 
was afforded at New Orleans of testing the method upon a still more extensive 
scale than heretofore. 
There is now no longer any doubt as to what are the prophylactic measures, 
nor as to how they should be carried out. The measures are neither complex, 
costly nor wasteful, but they require absolute conscientiousness, precision and 
rapidity of action to carry them out. From my observations this summer I am 
convinced that this is not realised, and that a very large part of prophylaxis is 
waste, brings about a sense of false security, and, I am of opinion, also unnecessary 
sacrifice of life. 
I will group and describe the measures necessary to adopt under the 
following heads : — 
In connection with 
Patient and 
infected mosquito. 
1. Early notification and danger of concealment of cases. 
2. Isolation Hospitals. 
3. Screening Patients. 
4. Fumigation and fumigating materials. 
