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extravagant and unnecessary. Then he asked for at least enough to enclose
the verandahs of the hospitals. This, too, was refused, and he was told that
there was no need of enclosing more than half the verandahs, and that even then
a part of the space should be solidly boarded up instead of screened."
In the meantime, however, yellow fever broke out among the Canal employees
and, according to Colonel Gorgas, " the force on the Isthmus was much
demoralised thereby. It was difficult to get men to come down, and when they
did come they were generally panic stricken and left us, This fear affected
all ranks of employees from the highest to the lowest, and while there were
hundreds of exceptions and plenty of plucky men who were not affected by the
prevailing panic, we could readily see that if the conditions as they existed in
1905 were to continue, the canal would never be finished. "
There is no doubt that this outbreak was a chief factor in procuring for the
sanitary authorities such facilities as afterwards enabled them, uninterruptedly
and almost without regard to expense, to bring the Canal zone into a sanitary
condition which has certainly not been equalled in any other area of similar
size in the tropics. In.General Abbot's book entitled "Problems of the Panama
Canal," it is stated that the yellow fever panic on the Isthmus reached its
height in June 1905, but prior to that date an order by the President of the United
States had announced that " the practical result of the operations of the Isthmian
Canal Commission appointed and acting under previous executive orders has not
been satisfactory, and requires a change in the personnel of the Commission and
in the instructions for its guidance. "
The new arrangements promulgated in that order came into force early in
the summer of 1905, and since that time sanitation on the Canal zone has
proceeded steadily and swiftly towards completeness.
In attempting to give an idea of present conditions it is necessary to deal
separately with the commission towns of Ancón and Cristobal and the native
cities of Panama and Colon. Complete freedom from yellow fever and almost
complete freedom from stegomyia mosquitoes is the outstanding character of the
present condition of Ancón and Cristobal, and it appeared to me very improbable
that, if present arrangements are maintained, these towns would ever again be
infected with yellow fever. In the first place they are quite separate from the
native cities—they are examples of the adoption of the principle of segregation
of the non-immune. In the second, although all the dwelling houses and most of
the public buildings are built of wood, these centres of population- are in every
necessary respect " model towns. " The ¿irrangements for sanitary control, and
the systems of sewerage, water-supply, drainage, lighting, street paving and
general cleanliness are exceedingly thorough, and every house is screened with
wire gauze in such a manner that mosquitoes are effectually excluded from the
verandahs and the whole interior of the house. In the third place the inhabitants
consist entirely of Commission employees who are not only under strict control,
but voluntarily co-operate and assist in all measures for the elimination of
mosquitoes—of which, it may be added, they are in wholesome dread. The
result is that in these towns stegomyia mosquitoes are almost non-existent. We
cannot say, however, that they have been entirely eradicated, because on April
7th, 1912, (which was near the end of a period of five months almost unpreced-
entedly dry weather) I was able to catch several adult stegomyia fasciata in my
bedroom in the Tivoli Hotel in Ancón ; but there can be no doubt that they have
been reduced to such a degree that, even if undiscovered cases of yellow fever
were introduced, the disease would not spread ; and on the whole I conclude that
these towns are uninfectible.
The cities of Panama and Colon still remain under the Republic of Panama,
but the authorities of the United States have jurisdiction in all that relates to
health conditions, and the standard of sanitation which they have set themselves
to attain is much higher than that aimed at in any other tropical town with which
I am acquainted—and very much higher, of course, than, in many non-tropical
towns of the same size in Europe or America. The original state of both cities
was exceedingly bad. Dr. Lacroisade, who for many years was medical director
of the French Company's hospital near Panama, described the roads in Colon as
being " veritable sewers " and in Panama as being " in a repulsive condition of