34 
come to the hospital if the patient is already in the throes of black 
vomit and exhibiting the prodromal symptoms of anuria 5 One of 
the saddest sights that can be continually seen in the hospitals is the 
entry of patients on the fourth to fifth day of the disease in a 
moribund condition. Many of these people would have recovered if 
only they had summoned a doctor or applied to the hospitals 
Numerous Stegomyia woyld have remained un-infeeted and conse¬ 
quently there would be far less possibility of other foreigners and 
non-immunes becoming infected, as the number of infe :ted Stegomyia 
would be greatly lessened. 
Why should such a condition prevail ? Is it the fault of the doctors 
and hospitals, the sanitary authorities, or the patient? 
It is not the fault of the doctors and hospitals, as they continually 
urge the necessity for early treatment. It is not for lack of the 
necessary fees, because a doctor, after the first visit, will advise an 
indigent patient to go to the hospital. The hospitals are ready and 
willing. The Hospital da Benificencia Portugueza has a screened 
ward especially kept for the reception of yellow fever ' suspects,’ where 
the patient remains until all doubts as to the diagnosis of the disease 
are cleared up. 
The sanitary authorities publish from time to time the by-laws 
relating to yellow fever. All cases of the disease must be immediately 
eported under penalty of a fine. This is not sufficient The by-laws 
Should be amended to the effect that all cases of fever occurring in 
of yeUow'fever ST™ ^ n °' from ■" •«** 
hours ’ Sh ° Uld be n ° tified withi " ‘he first twenty-four 
any form ° f f 
symptoms of fever. y m the ver y onset of 
All cases of fever in nn- • 
doctor within twenty-four hou^of 8 ** examined b y 
diagnosis notified in writing to the w T° f fever ’ and tl 
Foreigners unable to paVfor a docT \ Uthori ‘ i “' 
fever should on notification to theT' J SUfferin K fro 
by the doctor appointed by the •*. partment > be examine 
found suffering from yellow fever re Y ^ epartment > and, 
a - T- t0 the Hospital: 
Health Department of the City of Net" 0^^ ‘° this ^ct in' the r^a^T^ jj 
