At Jamaica, for the twenty years ending in 1836, the average
mortality was 101 per thousand, and in certain instances as high as 178.
One of the most dreaded of all infections, the periods of epidemics in
the Southern States have been the occasions of a widespread panic with
complete paralysis of commerce. How appalling the mortality is may be
judged from the outbreak in Philadelphia in 1793, when ten thousand
people died in three months.(5) The epidemics in Spain in the early part
of the nineteenth century were of great severity. A glance through
La Roche's great book(6) on the subject soon gives one an idea of
the enormous importance of the disease in the history of the Southern
States. Havana, ever since its foundation, had been a hotbed of yellow
fever. The best minds of the profession had been attracted to a solution
of the problem, but all in vain. Commission after commission had been
appointed, with negative results; various organisms had been described
as the cause, and there were sad illustrations of the tragedy associated
with investigations undertaken without proper training or proper
technique. By the year 1900, not only had the ground been cleared,
but the work on insect-borne disease by Manson and by Ross had given
observers an important clue.
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