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certain that other yellow fever centres in Brazil will follow the example 
of Rio, Santos, etc. Let Manaos and Para be in the front rank and 
prepared to reap the benefits which will occur from a yellow fever-free 
city and improved hygienic conditions. 
Manaos possesses a Director and a Sanitary Service. They have 
done their best to improve the hygienic conditions and to stamp out 
yellow fever from the city. Much has been accomplished, and there 
has been a considerable diminution in the number of yellow fever 
cases. We have seen various foci abolished. Much work has been 
performed with little money. 
If the present Director and personelle are allowed a fair amount 
of money and freedom of execution they will be able to put into 
operation the methods which have proved so successful in Rio, 
Havana, Panama and New Orleans. 
Gorgas claims that the most expeditious and certain method of 
freeing a place from yellow fever is by waging war on the Stegomyia 
and reducing the numbers to below the yellow fever ‘ point.’ Fumiga- 
gation and isolation should be practised, but the main efforts should be 
concentrated on reducing the number of Stegomyia breeding in the 
place. In the long run this will prove less expensive and will be 
easier of execution in Manaos. 
Manaos has a pipe-borne water supply and a good drainage system, 
two most valuable adjuncts in any anti-mosquito campaign. The area 
of Manaos proper is not extensive ; the work can therefore be 
concentrated. 
We have already experienced what can be accomplished by a small 
brigade. The Manaos Harbour, Limited, and the Booth Company 
in 1908 put one to three men on anti-mosquito work, specially to 
look after the precincts of their warehouses, offices, workshops, docks 
and lighters. We supervised the earlier inspections, and have verified 
the enormous diminution in the number of mosquitos and breeding 
spots. At first, the results were not satisfactory, as the mosquito 
‘ point ’ had not been reached, but later on the figures were highly 
gratifying. If such measures were instituted on a larger scale, the 
benefits would be experienced by all the firms and residents of the 
neighbourhood. 
