Every stagnant pool, every backwater in a brook, is swarming with them. The larvacide in that ash-can-as its name implies-is aimed in their direction. And there is a whole troop of Jamaican Negroes-allies of the ash-can-who carry the same prescription in tanks on their backs and shoot it with a hand spray into every puddle and body of standing water they can find. As I said before, the larvæ have to breathe. Every two minutes they must wriggle up to the surface for fresh air. This makes thirty times an hour, or 8,640 times in the twelve days of their larval life. If at any one of those times they get a lung full of larvacide, they never come up again.

Even without our interference a large number of the larvæ perish. Some are eaten by fish, some die from lack of proper food. Sometimes a freshet washes them down into the sea, or an extra high tide floods them with salt water. And sometimes the sun dries them out. But our larvacide corps immensely increases “infant mortality" among the mosquitoes.

But some of the Anopheline break through these two lines of attack and reach maturity-a very small number compared to the old days, but enough to make trouble. The Mosquito Brigade is held in reserve to deal with them. This division of the sanitary army might be compared to the coast artillery, for they fight behind fortifications-very elaborate fortifications of fine-meshed copper

screens.

"Mosquito netting" sounds simple. But just as in every other detail of this campaign, so here an immense amount of careful experimenting and expert knowledge has been utilized. Various brands of mosquitoes were captured and put into cages made of netting of different material and different sized meshes until the very best kind for this climate and work was discovered. A skillful architect worked out the problem of house planning so as to combine the most effective protection with the greatest economy of netting. Only copper wire will stand this climate. Even a few feet of waste on each house would mount up rapidly in cost. Such little details as the best springs and latches for the door and how to guard the screens from the toes and

elbows of romping children have been given searching study.

Nine days must elapse after an Anophe line female has bitten a malarious person before she becomes infectious. Every morning the Mosquito Brigade sallies out from headquarters on its murderous duty. If the enemy have been reported in any building, the brigade make a careful reconnaissance, discover how they made an entry, block it up, and then commence the slaughter with the skill and implements perfected by long experience. Nine mosquitoes out of ten go to sleep, after a meal of blood, somewhere on the wall, between nine and five feet above the floor. They seek out a dark place. Sometimes they hide in a closet or in the folds of hanging garments. But our men have nine days to get the mosquito in before she gets dangerous-and they generally do.

There is one feat of which the mosquito-killers boast. It was necessary at one time for some construction men to occupy one of the old French houses. The work in that vicinity would not last long enough to warrant the expense of screening, so the mosquitoes had free access by doors and windows. So deadly was the work of the Mosquito Brigade that the malaria rate in this temporary camp did not rise above the normal.

In the permanent quarters the screening is so thorough that the buzz of a mosquito is a rarity. If a person's sleep is disturbed, he notifies the Sanitary Department, just as you would call up police headquarters if you heard a burglar in your house.

There is one more important point in the plan of this campaign against malaria. No mosquito is dangerous that has not previously fed on a malarious person. And the minute a man is infected he is rushed to the hospital, where extraordinary care is taken to prevent any mosquitoes getting access to him.

First of all, they try to prevent the mosquitoes from laying their eggs, then they try to prevent the larvæ from hatching, then they screen all living-places and attack the adults, and, finally, they isolate all infected persons.

This elaborate campaign, from draining swamps to trained nursing in the hospitals, has resulted, not only in greatly reducing

the number afflicted with malaria, but, what is more marvelous, it has also greatly reduced its virulence. The explanation of this change in the type of the disease goes too deep into the theory of bacteriology for me. But the unexplained fact is striking enough. Probably more of the Frenchmen died from malaria than from yellow fever. At first our men died of it. To-day a fatal case is a rarity. What they used to call " black-water fever," a form of malaria which attacks the kidneys, and which is still common in the other lowlands of Central America, is almost unknown on the Canal Zone. Nowadays malaria means a couple of weeks of discomfort in the hospital and a week more of lazy convalescence.

And this anti-malaria campaign, of which I have spoken at length, is only part of the many-sided work of the Sanitary Department.

The war on the Stegomyia mosquito, the yellow-fever bearer, has been even more successful. This mosquito differs from the Anopheline, and is more easily exterminated, in that it is a domesticated animal. It lives and breeds only in or near human habitations. The water systems and sewers which we have built in Panama City and Colon did away with most of the rain-barrels and small artificial water-containers in which the eggs are laid, and wholesale fumigation of dwellinghouses destroyed most of the adults. No cases of yellow fever have originated in either city or among our employees since May, 1906. Vaccination has wiped out smallpox, and the Rat and Flea Brigade has practically exterminated the carriers of the bubonic plague.

year, they would have had about thirty deaths from disease. . . . I do not argue that in the Rio Grande reservoir we have found Ponce de Leon's spring of perpetual life, but merely that Panama is not so bad a place from the health point of view as is generally believed."

In the annual report dated August 23, 1907, he says: "During the year the working ability of the force was kept at its maximum. We averaged only twenty-nine per thousand absent from duty on account of sickness. This shows a very high state of efficiency as compared with any body of men of which I am able to get any record." And there has been no slump in the health conditions on the Zone since these reports were written, five and four years ago.

The diseases which our doctors are fighting down here are the same that the profession faces in New York or London. The ailments which we think of as distinctively tropical have been practically eliminated. Indeed, this process has gone so far that the doctors who are specializing in this field begin to find this a poor place to study. Samuel T. Darling, M.D., the Chief of the Board of Health Laboratory, has probably done as much as any other American in tropical diseases. I have here on my desk a handful of brochures he has written on the outlandish afflictions of man and beast which he has found on the Isthmus. "Sarcosporidiosis,"" Equine Trypanosomiasis in the Canal Zone," "Autochthonous Oriental Sore in Panama,” are a few of the titles-works which have caused his election to half the important medical societies of the world. But in his "Histoplasmosis: A Fatal Infectious Disease, Resembling Kola-Azar, Found among Natives of Tropical America," I find this paragraph. There is a note of pathos in it which will be appreciated by all those who collect rare objects and fear to have their hobby disturbed :

"In conclusion, it should be said that this disease, although no longer seen in Panama, is probably to be found in unhygienic and less salubrious regions of tropical America not yet disturbed by the sanitarian."

And if you talk with these men who are fighting disease-the engineer who with transit and chain is laying out drainage ditches; the man who has the responsi

bility of guarding the purity of the drinkingwater; the rat-catcher who strolls about with a Flobert rifle and a pocket full of poison; the red-headed young doctor who vaccinates you at Colon; or even the bacteriologist who finds his interesting researches "disturbed "—they will speak of themselves as "ditch-diggers." And no dynamite operator nor steam-shovel man will deny their right to say, "We've got sixty per cent of the dirt out of Culebra Cut," or "We beat the record laying concrete at Gatun this week."

One of the Larvacide Brigade pointed out to me a rusty mass of French machinery going to pieces in the jungle. They didn't know the difference between a mosquito and a bumblebee," he said by way of explanation. And he had hit the nail on the head. As likely as not, our mighty modern engines would be going to scrap alongside of the old French ones except for the devoted, intelligent work of these sanitary men.

The responsible head of the men who have done this marvelous work-and no words at my command can express the wonder of it—is William Crawford Gorgas, Chief Sanitary Officer. As Colonel Goethals is, in a way, paterfamilias of the community, so Colonel Gorgas is the family physician. Goethals is rather aloof and authoritative. Gorgas is genial and sympathetic. They say "he can give you liquid quinine and jolly you into thinking you like it." That is just what he did to the people of Panama City and Colon during the early yellowfever epidemic. Nobody likes to have his home fumigated. The Panamanians are immune to the fever. Most of them are too ignorant to understand the reason why they must be turned out of their homes for twenty-four hours. The more intelligent are easy-going, used to avoiding such inconveniences by bribing petty officials. All of them are, from a sanitary point of view, slipshod and careless. Gorgas succeeded in fumigating every house in Panama City within two weeks. He did it by jollying the people-slapping the men on the shoulders, smiling at the women, and playing "One little pig went to market, one little pig stayed at home," on the toes of the babies. Even the Panamanians who are most unfriendly to Americans admit that Gorgas is a good fellow, and

every child that knows him wants to sit in his lap.

Before coming here he had had charge of cleaning up Havana, and he knew how it should be done. Doubtless there were other American army doctors who had had similar experience and understood the work as well. But beyond the technique of his profession Gorgas knew the LatinAmerican people, their manner of life and their prejudices. He knew how to make them swallow quinine and at least half believe they liked it. It was necessary to fumigate those houses, and we would have done it even if it had been necessary to call in the marines and proclaim martial law. But Gorgas, with his wonderful tact, did it without using force or in any way increasing the enmity to the Gringo. It was not only a remarkably effective sanitary accomplishment, but an exceedingly clever bit of diplomacy.

They tell a story about Gorgas in Cuba, and people who know him say that it sounds true.

In the early days there were many who made light of the mosquito work. Gorgas went to one of his superiors for some money to carry on his campaign.

"Is it worth while to spend all this money just to saves the lives of a few niggers?" the Commandant protested. "That's not the point, General," Gorgas shot back at him. "We're spending it to save your life. it to save your life. And that's worth while."

He got the money.

Before a visitor has been long on the Zone he is sure to discover that there is a conflict of ideals between Gorgas and Goethals. The whole controversy-for that is what it amounts to-is, I think, one of temperament. Goethals, the practical, scrupulous administrator, makes a fetish of economy. "Low costs" are his hobby. Gorgas is imaginative and enthusiastic. He would like to kill every mosquito on the Isthmus, and then begin on the rest of the world. He does not know, unless some one tells him, and even then does not care, whether each mosquito costs five cents or five dollars. Delendum est. Goethals does not want to grant a single cent to the Sanitary Department which cannot be traced to added labor efficiency. One of the Goethals

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faction summed it up : Why, if you let Gorgas have his way, he'd spend the whole appropriation in six months !" Very likely he would. In a moment of enthusiasm he might offer a ten-dollar reward for every mosquito scalp brought to his office; but no one suggests that he would put any of it in his pocket.

On the other hand, the Gorgas faction portrays Goethals as endangering the life of our men by withholding necessary appropriations. Their own statistics, showing that the Zone is at least as healthy a place as New York City, proves that this portrayal is an exaggeration.

This conflict of ideals, distressing as it at first seems, is very probably a good thing for our Canal. The Sanitary Department has been run with less strict economy than any other. If there had not been a strong hand in check, there might have been gross extravagance. And as long as the sanitary crowd is looking for a chance to yell "Murder!" there is little probability that any dangerous economy will be risked in the department of health.

The whole affair would not be worth mentioning it has had no result down here beyond generating some personal ill feeling-if it were not for the fact that some steam has been blown off in the papers at home. And those who have rushed into print, as is generally the case

in such affairs, are not responsible heads of departments, but underling partisans, plus royalist que le roi, very much more bitter and extreme in their statements than their chiefs would dream of being. Neither the efficiency of the Sanitary Department nor the health of the men on the jobs has been disturbed.

A man with all Colonel Gorgas's remarkable fitnesses—his knowledge of sanitation, his familiarity with Latin people, his consummate diplomacy, his personal charm and magnetism, which inspire the men under him to their best effortswho had also a cool, calculating, bookkeeping head, might have accomplished the same results somewhat more economically. Very likely cheaper tile drains would have served in some places where concrete drains were laid. But, in spite of our recent ardor for economy and "business efficiency," if there is any one thing for which we, as a nation, are willing to stand a little extravagance, it is health. In this department we are more interested in results than methods. And of all the marvels of this immense Canal job of ours the great engineering triumphs, the high ideal of financial honesty, the spirit of united, collective action-there is nothing which stands out more wonderful than the results accomplished by the men and ash-cans under Colonel Gorgas.