"At the expiration of four hours the squad returns and the door is partially opened to allow the men to enter. The walls, ceiling, and floor are carefully swept, and the clothing is once more shaken. Any mosquitoes formed to be still living are thrown into the pans and those that are dead are kept in small boxes to be sent to the laboratory of Las Animas Hospital for identification.
"Petroleum is now poured into all re ceptacles where mosquito larvae may grow. The inspector meanwhile an inquiry as to the place where the pa tient may have been infected, the he visited in the last five days previous to his illness, and the persons that are likely to have been bitten at the same time and. place with the patient.
"The inspector takes also a census of the non-immunes who live in the house and its immediate neighborhood. Al] this information is made the subject of a report to the city health officer. The report should contain also any recom mendations that may be deemed useful as to the general sanitary condition of the house.
"The Health Department of Havana is prepared to disinfect, in the manner above described, twenty-four houses in one day. As many as twenty-two have been disinfected with an expenditure of five hundred pounds of pyrethrum.
"Before leaving the house a certificate is obtained from the family to the effect that no damage has been done to the property in the process of disinfection, or, if otherwise, a note is taken of com plaints that may be made.
"With respect to the pyrethrum pow der, it should be stated that the smoke does not kill all the mosquitoes; but at the end of four hours those that are not killed are paralyzed and can be readily gathered in the manner I have de scribed. The smoke produces, also, a very faint east upon exposed surfaces of white goods when they are lying in a horizontal position. Tobacco is as ef fective as pyrethrum, but it leaves a very offensive odor and a more decided stain than pyrethrum. Guava leaves have also been tried, but they are less ef fective." Even in a filthy tropical city, without proper sewerage, without any sanitary standard whatever, the work of disin fection can be pushed to a successful issue.
This fact is fairly in evidence; the foci of yellow fever are in certain defi nite places in a city where it is endemic. The habitat can be located, and as fast as one appears it should be guarded closely, and, with all of its belongings, disinfected thoroughly, and, as an added precaution, redisinfected at intervals during the danger period; these places should be kept under continual surveil lance and treatment, and no pains or expense should be spared to render the contagion at such points inert.
Nearly all of the best men, men of scientific attainments who have had practical experience in the care of yel low fever. and in the sanitation of cities wherein the fever was epidemic, arc now engaged in laboratory work, en deavoring to demonstrate which germ is responsible for this scourge. The object is a most laudable one.
But would not the interests of hu manity be better conserved if the sani tary measures in the cities wherein yel low fever is epidemic were under the constant watch and control of some such men? After an epidemic, this important work—looking to a prevention of a re currence—is often left in the hands of inexperienced and careless persons. Why should not some of these men de vote their entire time and attention to preventive measures, giving intelligent supervision to methods that we have, and know to be reliable? _Major L. C. Carr (Phila. Med. Jour., April 0, I001).
The first special measure of preven tion should be to protect the sick indi vidual against the bites of mosquitoes, and the state that this can best be accomplished by thorough screening and with immovable screens. As it is possible that mosquitoes that have al ready bitten the sick individual may have escaped into other apartments of the house, they recommend that these should be closed tightly and subjected either to sulphur or to formaldehyde disinfection or to the fumes of pyreth rum. They regard sulphur as the best agent. In a well-closed room, one to one and a half hours of sulphur fumiga tion, in a proportion of I pound to 1000 cubic feet of air-space, will suffice to de stroy all mosquitoes. Reed and Carroll (Medical Record, Oct. 26. 1901).