Harper's Weekly
July 22, 1905

The First Mountain To Be Removed

                Artist: William Allen Rogers
 

                In this cartoon, Uncle Sam points to the culprit impeding progress on the
                Panama Canal; it is Yellow Jack, a nickname for yellow fever.  The
                mask over Yellow Jack's fierce, skeletal visage marks it as a bandit who
                steals human lives (note the vultures circling and perched on his sombrero).
                The depiction of yellow fever as a mountain emphasizes that it is a
                monumental problem that must be eradicated before construction on the
                Panama Canal (including blasting through real mountains) can be effective.
                Beside Uncle Sam stands President Theodore Roosevelt, arms akimbo, who
                is ready for battle in his Rough-Rider outfit.

                In 1881, a French company under the direction of Ferdinand de Lesseps
                began excavation for an interoceanic canal across the Isthmus of Panama.  In
                1903, the Hay-Bunau-Varilla Treaty gave the United States sole rights to
                construct and operate a canal in Panama.  The next year, Lessepsís former
                company sold its holdings to the United States.  Yellow fever, malaria, and
                other tropical diseases plagued both the French and American efforts to
                construct the Panama Canal, but it was yellow fever that provoked the most
                fear.

                Yellow fever made its first appearance at the project during the summer of
                1881 when the French company started digging.  The company's records list
                60 deaths during the first year (almost certainly an underestimate), but de
                Lesseps denied that there was an epidemic in Panama.  In fact, more
                probably died then, as they certainly over the entire period of construction,
                from malaria than from yellow fever.  There was no immunity to malaria, but
                because it was a constant presence in the region, it was known and
                expected.

                Yellow fever did leave its survivors with immunity, yet it occurred in
                epidemics that swept through areas with swift vengeance.  Many of the
                Panamanian natives had childhood immunity to yellow fever, so it was the
                French, Americans, and other outsiders who suffered most from "the white
                man's disease."  The symptoms of yellow fever were also worse than those of
                malaria.  With both diseases, victims had insatiable thirst, chills, and high
                fever.  Yellow-fever sufferers, however, endured severe aches in their heads,
                backs, and legs; became extremely restless; turned yellow, especially in the
                face and eyes; and vomited dark blood.  People often refused to touch
                victims for fear of contracting yellow fever, and quickly buried the dead.

                When the French began their Panama Canal project, there was no cure for
                yellow fever, although quinine was taken as a malaria preventative.  The
                predominant theory among scientists and the public was that both diseases
                were caused by poisonous vapors, such as from swamps or marshes (malaria
                is Italian for "bad air").  Sewage, rotting animal carcasses, the patient's
                clothing, and other filth were considered as contagions for the airborne
                disease.  People tried to avoid the wind and night air when yellow fever was
                present.

                In 1848, however, Dr. Josiah Nott of Alabama had published a paper in the
                New Orleans Medical and Surgical Journal in which he denied that vapor
                causation theory and hypothesized that insects, perhaps mosquitoes,
                transported yellow fever and malaria.  In the 1850s, Dr. Lewis Beauperthuy
                in Venzuela and Dr. Albert Freeman Africanus King in Washington, D.C.,
                came to similar conclusions.  The medical community and the public, though,
                ignored their conjectures.

                In 1881, the year the Panama Canal project commenced, Dr. Carlos Juan
                Finley, a physician in Havana, Cuba, often the site of yellow fever epidemics,
                not only observed that mosquitoes spread yellow fever, but correctly
                identified the exact species (out of 800) that was the carrier.  It was a
                wonderful example of scientific imagination, but Dr. Finley could never
                produce evidence to support his theory.  Thus, he, too, was ignored.

                Meanwhile, in the French hospital in Panama, bed legs set in pans of water to
                keep ants from climbing on the patients provided a breeding ground for
                mosquitoes.  There were also no screens on windows or doors, and open
                pots of water abounded in homes (for drinking) and in gardens (to keep pests
                off plants).

                Finally, in 1897-1898, Dr. Ronald Ross, an English physician in India, proved
                that a certain type of mosquito absorbed a malaria-causing parasite into its
                salivary gland by biting a malaria victim.  The parasite multiplied within the
                mosquito, which then spread the disease by biting healthy people.  Dr. Ross
                was awarded the Nobel Prize for his momentous discovery.

                In 1901, a yellow fever epidemic erupted in Havana, which was under the
                control of American occupation forces following the Spanish-American War
                of 1898.  Dr. Walter Reed, who headed the American medical corps in
                Cuba, agreed that the mosquito was also to blame for spreading yellow
                fever.  Although initially skeptical, Dr. William Gorgas convinced Reed, his
                superior, to test the theory by eradicating the mosquito from Havana.
                Amazingly, in eight months, Gorgas and his men were able to do just that,
                halting the yellow fever epidemic.  Playwright Sidney Howard dramatized
                their heroism in his play, Yellow Jack (which was later made into a movie).

                When the United States took over the Panama Canal project in 1904, chief
                engineer John Walker of the Isthmian Canal Commission called the mosquito
                theory "balderdash," despite Ross's Nobel Prize work on malaria and
                Gorgas's success against yellow fever in Havana.  The rest of the commission
                agreed.  The health officer appointed to the project, though, was Dr. Gorgas,
                who planned to attack the problem of yellow fever first.  In Panama,
                however, he faced a large geographic area, limited supplies, and resistance
                from his commanding officers who thought chasing mosquitoes was a waste of
                time, money, and manpower.

                Beginning in November 1904, cases of yellow fever began to appear, and in
                January 1905, headlines in American newspapers blazed "Yellow Jack in
                Panama!"  Panic was spreading in Panama as 200 of the staff resigned over a
                two-week span, and three-quarters of all Americans left before the situation
                was under control.  President Roosevelt, who had witnessed cases of yellow
                fever while fighting in the Spanish-American War, realized the Canal
                Commission members were a major obstacle, so forced their resignation.
                Roosevelt named John Stevens as the new chief engineer.

                With the president's blessing, Stevens cut red tape and allocated all the
                resources necessary to end the yellow fever epidemic.  Whereas Gorgas's
                budget had previously been $50,000, the physician now got $90,000 just for
                screen-wire.  Gorgas and his workers put screens on windows and doors,
                fumigated houses, isolated victims, oiled cisterns weekly, and replaced
                standing water with running water.  Not surprisingly, the task took longer than
                in Havana, but incidents of yellow fever dropped dramatically by the fall of
                1905, and within a year-and-a-half, the Panama Canal Zone was rid of the
                dreaded disease.

                Robert C. Kennedy