In 1906, out of every 1000 employees there were admitted to the hospital from malaria 821; in 1907, 424; in 1908, 282; in 1912, 110; in 1915, 51; in 1917, 14. The fatalities from the disease have fallen from 233 in 1906 to 154 in 1907, to 73 in 1908 and to 7 in 1914. The death rate for malarial fever per 1000 population sank from 8.49 in 1906 to 0.11 in 1918. Dysentery, next to malaria the most serious of the tropical diseases in the Zone, caused 69 deaths in 1906; 48 in 1907; in 1908, with nearly 44,000, only 16 deaths, and in 1914, 4.[*] But it is when the general figures are taken that we see the extraordinary reduction that has taken place. Out of every 1000 engaged in 1908 only a third of the number died that died in 1906, and half the number that died in 1907.

[*] Figures for recent years supplied by editors.

In 1914, the death rate from disease among white males had fallen to 3.13 per thousand. The rate among the 2674 American women and children connected with the Commission was only 9.72 per thousand. But by far the most gratifying reduction is among the blacks, among whom the rate from disease had fallen to the surprisingly low figure in 1912 of 8.77 per thousand; in 1906 it was 47 per thousand. A remarkable result is that in 1908 the combined tropical diseases--malaria, dysentery and beri-beri--killed fewer than the two great killing diseases of the temperate zone, pneumonia and tuberculosis-- 127 in one group and 137 in the other. The whole story is expressed in two words, EFFECTIVE ORGANIZATION, and the special value of this experiment in sanitation is that it has been made, and made successfully, in one of the great plague spots of the world.

Month by month a little, gray-covered pamphlet was published by Colonel Gorgas, a "Report of the Department of Sanitation of the Isthmian Canal Commission." I have been one of the favored to whom it has been sent year by year, and, keenly interested as I have always been in infectious diseases, and particularly in malaria and dysentery, I doubt if anyone has read it more faithfully. In evidence of the extraordinary advance made in sanitation by Gorgas, I give a random example from one of his monthly reports (1912): In a population of more than 52,000, the death rate from disease had fallen to 7.31 per thousand; among the whites it was 2.80 and among the colored people 8.77. Not only is the profession indebted to Colonel Gorgas and his staff for this remarkable demonstration, but they have offered an example of thoroughness and efficiency which has won the admiration of the whole world. As J. B. Bishop, secretary of the Isthmian Canal Commission, has recently said: "The Americans arrived on the Isthmus in the full light of these two invaluable discoveries [the insect transmission of yellow fever and malaria]. Scarcely had they begun active work when an outbreak of yellow fever occurred which caused such a panic throughout their force that nothing except the lack of steamship accommodation prevented the flight of the entire body from the Isthmus.

Prompt, intelligent and vigorous application of the remedies shown to he effective by the mosquito discoveries not only checked the progress of the pest, but banished it forever from the Isthmus. In this way, and in this alone, was the building of the canal made possible. The supreme credit for its construction therefore belongs to the brave men, surgeons of the United States Army, who by their high devotion to duty and to humanity risked their lives in Havana in 1900-1901 to demonstrate the truth of the mosquito theory."[7]

[7] Bishop: The French at Panama, Scribner's Magazine, January, 1913, p. 42.