New-York tribune., 1886-08-22
THE PANAMA CANAL.
III.
DISEASE AND THE WEAPONS WITH WHICH
1T Is EOIIGHT

| Colon, August 4.
certain groi fascination attaches to tho idea
OF a com munity in which death has become COM
monplace. A man who establishes himself in Colon
| or Panama, or who undertakes to spend any con-
siderable time oil the llne knows that the aggre-
gate mortality around HIM is something frightful.
tie knows OF specific cases IN which tho statistics
OF a small number of lives have been such as TO
indicate certain Heath his portion. lie knows
that within the last five months the death-rate
among the chief resident officials of the canal COM
pauy has been more than SO per cent, a mortality
which IL it extended to all classes of the commu
nifty would exterminate every man. woman ana
| child on the lsthmus in six months. sHe knows
perhaps, that the 1st Of last October thirty
Italians arrived at Colon under agreement TO serve
the Societe des Travaux Publques ct Constructions
| de Paris as foremen that of these twenty-nine
| were in perfect health and robust condition and
the remaining one only suffering from debility
caused by excessive sea-sickness that they were
at once sent to the Enterprise d'Emperador. where
they were exceentiy toused and Lad every advan-
tage OF medical attendance; that on the 2Sd oil the
same month only five of them snrvived-a death
rate which. If 1t were universal. would depopulate
the earth in less than month.
lie knows, it is true. of one who has lived
on the lsthmus nnete years. and who is still In
good health But he knows too, of men who have
lived there for ten and fifteen years. and then died
after only four or five days illness. All this is
perDiexing. But he is the more perplexed when
ne stops to consider that in tho instance OF the hve
chief officials out Of six and the twenty-five Italian
foremen out of thirty. the mortality was not from
a contagiOn, was not even from a uniform infec-
tion. One mal died of common remittent n.ala.
rial fever another of tho most vrulent type OF yell
low fever, another Of bilious fever OF an IN dis
tinct character, fourth Of acute Brghts disease
following successfully resisted case of yellow
fever. lie knows that he ought not to drink heav-
lily. But he discovers that the climate superin-
duces an intoIerable lassitude which nothing but
frequent stimulants seems to relieve. One physi-
clan prescrbes to him regimen which is thor
oughy improbable, tells him to avoid the hot sun.
the sudden showers. the poisonous cir or the night
and early morning. Another physician shrngs his
shoulders and says: My dear fellow, dress. eat,
drink, live Just as you did at home. and don't
worry. None Of us know anything about the pre-
disposing conditions of these fevers But we are
not all OF us candid enough to say so. But, above
all, don't worry" There would be some comfort
ip this last genial counsel If it were not interrupted
by the arrival of messenger to inform the doctor
that such and such man has been taken Ill, that
another is dying, and third Just dead.
The plain truth Is the only safe course for n man
on the Isthmus to pursue is to leave the Isthmns
immediately. and even then he may. for all that he
knows. carry with HIM the embryo of fatal ILL
ness which may not develop itself for weeks and
even months. II ever a country seemed to have
incurred the dispeasure of Divine Providence that
country is the lsthmus Of Panama
Special interest attaches to peculiar form of
septic maIarlal fever occasionally met with in
Panama and Colon. This fever has but recently
been recognized by the official physicians and no
description Of 1t has yet been published either in
medical journals or otherwise. 1t is known among
the physicians as Bettelheims fever. 1t is of
continuous type. does not partake of the charac-
terstics either of typhoid or yellow fever and yet
Is not amenable to tho qulnino treatment. Its
course is very much that of typhoid but ostmOrtem
exam nations fail to show the characteristic
typhoid LESSONS From pathological point of Wow
it is to be regretted that the religious tenets domi
nant among the foreign residents in Panama make
It impossible to perform aut0psics except IN some
isolated cases And it is on ing to this crcnm-
stance that the fever in question was NOT long
since described and discussed in tho literature of
epidemiology. The post-mortem examinations
have now. however. aggregated sufficiently to
place beyond dispute the fact that this fever Is
clearly distinct from typhoid Its traces core
bral congestion, gastric and enteric henorrhagc
illusions. and in general the appearances consc-
laing and cxpcctant treatment, with efforts t"
arrest each symptom as it is developed seems to be
the only therapeutic course. Most of tho cases
occur among we'll to- do residents of Panama.
Tho canal company evinces its recognition OF
the great mortality alike by the assiduity with
which it's officers struggle against It, and by the
sedulOus with which they endeavor to conceal
it from the world at large. The one effort in some
instances tends to embarrass tho other. Every
difficulty by which the company is beset requires
two distinct elorts-it it must be overcome and 1t
must also be kept secret from the supporters oil
tho project who would otherwise be discouraged.
The enterprise is thus douby crippled. The canal
company has organized q costly and excellent
medical establishment constructed hospitals on the
most approved pian and with its customary incon-
| sstency proclaimed to the world satisfactory
condition of public health on the lsthmus; which
IL it in fact existed would prove all this outlay to
have been magnificent folly. But in this respect,
at least the company fails to do itself Justice Tho
extensive medical establishment which it maintains
is an urgent necessity, although it may very well be
that it is not conducted at the least possible cost
compatible with its efficiency It's hospitals and
its medical staff not disproportionate to tho
amount Of disease with which they havo to cope.
but it is quite true that they are monstrousy dis
proportionate to the magnitude of the undertaking
asa whole It is AZ if the whole of ship were SO
far filled with medical stores for her crew that sho
was unable TO carry remunerative amount OF
cargo. To O certain extent. this enormous expense
was inherent in the nature of tho enterprise More
over. unhappily. it was magnided by tho insane
recklessness displayed BY the company's servants
whose habit Of life is such would result III wide
spread disease In any hot climate, evea themosr
Salubrious.
The hospitals, at the foot of Mount Aneon, are
splendid monument to the enlightened lberality
of o governing body most Of whose work shows
the most shocking ncapabilty Basing my e1-
pectatlons on what else | had seen OF the COM
pany's regime. looked for lavish waste. official
corruption. and tentative methods. There are. OF
course. indications OF needless redtape ana exces
siye bureaucracy at the hOspltals. aud there viii