University of Virginia Library

STATE OF THINGS BEFORE THE DISCOVERY OF MOSQUITO TRANSMISSION

Other infectious diseases, tuberculosis, for instance, may cause a greater death-rate and bring about more misery and distress, even to-day, than yellow fever has produced at any one time; but no disease, except possibly cholera or the plague, is so tragic in its development, so appalling in its action, so devastating in its results, nor does any other make greater havoc than yellow fever when it invades non-immune or susceptible communities.

For two centuries, at least, the disease has been known to exist endemically, that is, more or less continuously, in most of the Mexican Gulf ports, extending its ravages along the West India Islands and the cities of the Central and the South American coast.

In the United States it has made its appearance in epidemic form as far north as Portsmouth, N. H. At Philadelphia in 1793, more than ten per cent. of the entire population died of yellow fever. Other cities, like Charleston, S. C., suffered more than twenty epidemics in as many summers, during the eighteenth century. In the city of New Orleans, the epidemic which developed in the summer of 1853 caused more than 7,000 deaths. Later, in 1878, yellow fever invaded 132 towns in the United States, producing a loss of 15,932 lives out of a total number of cases which reached to more than 74,000: New Orleans alone suffered a mortality of 4,600 at that time. Recently (1905), this city withstood what is to be hoped shall prove its last invasion, which, thanks to the modern methods employed in its suppression, based upon the new mosquito doctrine, only destroyed about 3,000 lives.

It is by contemplating this awful record, and much more there is which for the sake of brevity I leave unstated, that one realizes the boon to mankind which the successful researches of the Army Board have proved. The work of prevention, the only one that may be considered effective when dealing with the epidemic diseases, was entirely misguided with regard to yellow fever until 1901: the sick were surrounded by precautions which were believed most useful in other infectious diseases, the attendants were often looked upon as pestilential, and so treated, in spite of the fact that evidence from the early history of the disease clearly pointed to the apparent harmlessness even of the patients themselves. All this notwithstanding, cases continued to develop, in the face of shotgun quarantine even, until the last non-immune inhabitant of the locality had been either cured or buried.

The mystery which accompanied the usual course of an epidemic, the

poison creeping from house to house, along one side of a street, seldom, crossing the road, spreading sometimes around the whole block of houses before appearing in another neighborhood, unless distinctly carried there by a visitor to the infected zone who himself became stricken, all this series of peculiar circumstances was a never-ending source of discussion and investigation.

In the year 1900, Surgeon H. R. Carter, of the then Marine Hospital Service, published a very interesting paper calling attention to the interval of time which regularly occurred between the first case of yellow fever in a given community and those that subsequently followed; this was never less than two weeks, a period of incubation extending beyond that usually accorded to other acute infectious diseases. The accuracy of these observations has later been confirmed by the mosquito experiments hereinafter outlined.