There was at first a serious difficulty relating to the necessary
administrative control by a sanitary officer. In an interview which Dr.
Welch and I had with President Roosevelt, he keenly felt this difficulty
and promised to do his best to have it rectified. It is an open secret
that at first, as was perhaps only natural, matters did not go very
smoothly, and it took a year or more to get properly organized. Yellow
fever recurred on the Isthmus in 1904 and in the early part of 1905. It
was really a colossal task in itself to undertake the cleaning of the
city of Panama, which had been for centuries a pest-house, the mortality
in which, even after the American occupation, reached during one
month the rate of 71 per thousand living. There have been a great many
brilliant illustrations of the practical application of science in
preserving the health of a community and in saving life, but it is safe
to say that, considering the circumstances, the past history, and the
extraordinary difficulties to be overcome, the work accomplished by
the Isthmian Canal Commission is unique. The year 1905 was devoted to
organization; yellow fever was got rid of, and at the end of the year
the total mortality among the whites had fallen to 8 per thousand,
but among the blacks it was still high, 44.
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