Sanitation in Panama — Inside the Classic

li was identical with the hog-cholera bacillus. They made this demonstration while comparing the bacillus X of Sternberg with the bacillus icteroides of Sanarelli. The work was carried on by them during the years 1897 and 1898, at the laboratory of the Army Medical Museum in Washington. The investigation was undertaken at the request of General Sternberg.

In 1899 our Public Health Service published the report of a board of medical officers who had been sent to Havana to investigate Sanarelli’s organism. This report made a great impression. Surgeon-General Wyman, in his letter transmitting the report says:

The findings of this Commission, verifying the discovery made by Sanarelli, and making still further advances than did Sanarelli himself by determining the specificity of the bacillus icteroides, and that the primary infection of yellow fever is received through the respiratory tract, in other words, verifying one discovery and making others of almost equal importance, at the same time eliminating incorrect theories, must be considered a notable achievement in medical science and one of the greatest practical value to the people of the United States and other countries infected, or liable to be infected by yellow fever.

In view of the widespread interest which the report will excite and the practical deductions to be drawn therefrom, I have respectfully to request authority to have the same printed.

The findings of this Commission were:

First. That the microörganism discovered by Professor Giuseppi Sanarelli, of the University of Bologna, Italy, and by him named “bacillus icteroides” is the cause of yellow fever.

Second. That yellow fever is naturally infectious to certain animals, the degree varying with the species; that in some of the rodents local infection is very quickly followed by blood infection, and that, while in dogs and rabbits there is no evidence of this subsequent invasion of the blood, monkeys react to the infection the same as man.

Third. That infection takes place by way of the respiratory tract, the primary colonization in this tract giving rise to the earlier manifestations of the disease.

Fourth. That in many cases, probably a majority, the primary infection, or colonization, in the lungs is followed by a “secondary infection,” or a secondary colonization in the blood of the patient. This secondary infection may be complicated by the coinstantaneous passage of other organisms into the blood, or this complication may arise during the last hours of life.

Fifth. There is no evidence to support the theory advanced by Professor Sanarelli that this disease is primarily a septicemia, inasmuch as cases do occur in which the bacillus icteroides cannot be found in the blood, or organs in which it might be deposited therefrom.

Sixth. That there exists no casual relationship between the bacillus X of Sternberg and this highly infectious disease; and that this bacillus X is frequently found in the intestinal contents of normal animals and of man, as well as in the urine and the bronchial secretion.

Seventh. That, so far as your Commission is aware, the bacillus icteroides has never been found in any body other than of one infected with yellow fever; and that whatever may be the cultural similarities between this and other microörganisms, it is characterized by a specificity which is distinctive.

Eighth. That the bacillus icteroides is very susceptible to the influences injurious to bacterial life, and that its ready control by the processes of disinfection, chemical and mechanical, is assured.

Ninth. That the bacillus icteroides produces in vitro as well as in vita a train of the most marked potency; and that, from our present knowledge, there exists a reasonable possibility of the ultimate production of an antiserum more potent than that of Professor Sanarelli.

About the same time an officer of the Public Health Service, Dr. H. R. Carter, was making in Mississippi his epoch-marking observations upon the extrinsic incubation of yellow fever. Measured by the results produced, this was one of the most important papers ever written. Yet as high an authority as the Surgeon-General of the Public Health Service expected the greatest results to flow from the conclusions reached by this Board, and did not notice the report from his subordinate concerning the extrinsic incubation of yellow fever. The conclusions of his Board turned out to be all wrong and useless as to results. The report of Carter turned out to be pure gold, and was one of the great steps in establishing the true method of the transmission of yellow fever. I do not say this in criticism. It is almost impossible for contemporaries to judge the true value of discoveries, or to give the proper position to the men of their own time who make these discoveries.