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 entir