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 be 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.

One disease has still a special claim upon the public in this country.  Some fourteen or fifteen years ago, in an address on the problem of typhoid fever in the United States, I contended that the question was no longer in the hands of the profession.  In season and out of season we had preached salvation from it in volumes which fill state reports, public health journals and the medical periodicals.  Though much has been done, typhoid fever remains a question of grave national concern.  You lost in this state(7a) in 1911 from typhoid fever 154 lives, every one sacrificed needlessly, every one a victim of neglect and incapacity.  Between 1200 and 1500 persons had a slow, lingering illness.  A nation of contradictions and paradoxes—­a clean people, by whom personal hygiene is carefully cultivated, but it has displayed in matters of public sanitation a carelessness simply criminal:  a sensible people, among whom education is more widely diffused than in any other country, supinely acquiesces in