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is not well situated nor is it edequately equipped for dealing
with the passengers of a ship infected with yellow fever. It is
on the mainland and within a mile of a considerable population
and it would be difficult, if not impossible, to isolate
patients who were suffering from an infectious disease which is
conveyed by insects. Even for the general purposes of a quaran-
tine station it is not a desirable one, e.g. for arresting the
spread of cholera. As to the probability of an isolation stat-
ion being an imperious demand in the near future the following
argument may be advanced:- That the measures to be taken by the
port authorities of the yellow fever zone in Central America
will reduce to a minimum the risk of the diɛcase being conveyed
on board a ship; that a second line of defence has to be broken
through by such a ship at her subsequent ports of call; and that
the length of the voyage and the latitudes traversed will fur-
ther obviate the risk. The first end second of those statements
may be correct in the great majority of instances, but they do
not altogether exclude the possibilities in the case, for yellow
fever may appear days or weeks after a ship has sailsd, an
occurrence which is by no means unknown in the history of this
disease; and, as to the third statment it is known that the
stegomyia fasciata can survive the passage of latitudes outside
the tropics. Many authorities, including Sir Patrick Manson
allege that yellow fever will undoubtedly spread to Asia after
the opening of the Panama Canal, unless stringent preventive
measures be adopted.
5. Although all needful caution must beexercised before recommending action to be taken which will involve a consider- able outlay in establishing and maintaining a station properly equipped and with a sufficient staff, on the other hand it would be almost impossible to meet the call for such a place by the methods of emergency, while the lengthy warning es to the need for being ready for such an emergency together with the impor- tance of the results of a state of unpreparedness causes me to
advise
at
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