( 66 ) 
was Chamilicon, eight miles from San Pedro. The fever broke out on July 
i st, and approximately there have been 160 cases with 49 deaths. Sometime 
in July Yellow fever was declared at Choloma ; the infection was 
attributed to San Pedro, there were 148 cases and 59 deaths, but the 
disease was still reported there in the middle of November. 
It is again worthy of note that between infected places on the line, 
intermediate towns appear to have remained free, and similarly with the 
Honduranian Coast towns, notably Omoa, close by Cortes, Ceiba, 1 ruxillo, 
Ruatan, Utila, the fever does not appear to have broken out. I he occuirence 
of fever along the Puerto Cortes line appears to coincide with what had 
taken place on the Puerto Barrios line, and the same doubts occur as to 
whether the disease in the interior towns was secondary to the coast tow n 
infection or not. The Cortes line is 57 miles long, and is the first segment 
of the Honduranian Interoceanic line to connect Puerto Cortes with Amapala 
on the Pacific. The dates of infection of San Pedro, Chamilicon and Cholomo, 
if correct, shows that infection probably came irom Puerto Cortes, and this 
would constitute another example of the way in which infection spreads by a 
trade route. With regard, however, to the source of the infection of Cortes 
itself, it is regarded as possible, for it to have reached that port overland from 
Gualan by the Santa Barbara trail. This is tantamount to attributing the 
blame to Guatemala, and to assuming that the fever in Gualan was Yellow 
fever. 
The distribution of the population of British Honduras and of the Central 
American Republics are not similar. In British Honduras the population is 
gathered at the coast towns and the traffic is concentrated there ; in the inter ioi 
the population is exceedingly sparse, there are no large towns or large trade 
routes and the greater part is virgin territory. I he surrounding Republics, on 
the other hand, have been long settled, the chief towns are in the interior, and 
there is a continuous trade between town and town and between the towns 
of adjacent Republics. The coast towns are of more recent development and 
are due to the increasing trade with foreign countries. We know comparatively 
little, however, of the exact disease returns of the towns in the interior, 
Medical Officers of the United States Public Health and Marine Service are 
not stationed there to report weekly. In consequence it becomes very difficult, 
in countries with thickly populated interiors, to exclude the possibility of infection 
spreading from some endemic focus in the interior to the coast towns. Con- 
siderations like these emphasise the necessity of putting the coast towns in 
such a sanitary position that the taking root and spreading ot infectious 
diseases in them will in future be rendered exceedingly difficult. 
NICARAGUA. 
Ports : Cape Gracias, Bluefields, and Grevtown. 
Cape Gracias (Port Didrick ?) is a small town at the extreme north-east 
corner of the mosquito coast ; it is the port of the mining industries of 
Nicaragua. Fruit steamers call. No Yellow fever was reported this 
summer. 
