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However, a decision was necessary, and in 1905 a board of consulting or advisory engineers was appointed, mainly to consider whether the ca.n.a.l should be constructed at high-level or sea-level. Five members were appointed by European governments, and the president was Major-General George W. Davis, formerly of the United States army. The instructions given to this board by President Roosevelt will afford a very clear idea of the problem it had to solve:--

There are two or three considerations which I trust you will steadily keep before your minds in coming to a conclusion as to the proper type of ca.n.a.l. I hope that ultimately it will prove possible to build a sea-level ca.n.a.l. Such a ca.n.a.l would undoubtedly be best in the end, if feasible; and I feel that one of the chief advantages of the Panama route is that ultimately a sea-level ca.n.a.l will be a possibility.

But while paying due heed to the ideal perfectibility of the scheme from an engineer's standpoint, remember the need of having a plan which shall provide for the immediate building of a ca.n.a.l on the safest terms and in the shortest possible time. If to build a sea-level ca.n.a.l will but slightly increase the risk, then, of course, it is preferable. But if to adopt the plan of a sea-level ca.n.a.l means to incur a hazard, and to insure indefinite delay, then it is not preferable. If the advantages and disadvantages are closely balanced, I expect you to say so. I desire also to know whether, if you recommend a high-level multi-lock ca.n.a.l, it will be possible, after it is completed, to turn it into or subst.i.tute for it, in time, a sea-level ca.n.a.l without interrupting the traffic upon it. Two of the prime considerations to be kept steadily in mind are:

First.--The utmost practicable speed of construction.

Second.--Practical certainty that the plan proposed will be feasible; that it can be carried out with the minimum risk.

The quant.i.ty of work and the amount of work should be minimized as far as possible.

There may be good reason why the delay incident to the adoption of a plan for an ideal ca.n.a.l should be incurred; but if there is not, then I hope to see the ca.n.a.l constructed on a system which will bring to the nearest possible date in the future the time when it is practicable to take the first ship across the isthmus--that is, which will in the shortest time possible secure a Panama waterway between the oceans of such a character as to guarantee permanent and ample communication for the greatest ships of our navy and for the larger steamers on either the Atlantic or the Pacific. The delay in transit of the vessels owing to additional locks would be of small consequence when compared with shortening the time for the construction of the ca.n.a.l or diminishing the risks in its construction.

In short, I desire your best judgment on all the various questions to be considered in choosing among the various plans for a comparatively high-level multi-lock ca.n.a.l; for a lower level, with fewer locks; and for a sea-level ca.n.a.l.

Finally, I urge upon you the necessity of as great expedition in coming to a decision as is compatible with thoroughness in considering the conditions.

The board went to the isthmus and investigated the subject with great care. In January 1906 they issued three reports. A majority of eight to five p.r.o.nounced in favour of the sea-level scheme "as the only one giving reasonable a.s.surance of safe and uninterrupted navigation." "Such a ca.n.a.l," it said, "can be constructed in twelve or thirteen years'

time; the cost will be less than $250,000,000; it will endure for all time."

The minority were just as confidently in favour of a high-level ca.n.a.l.

They concluded:--

In view of the unquestioned fact that the lock ca.n.a.l herein advocated will cost about $100,000,000 less than the proposed sea-level ca.n.a.l; believing that it can be built in much less time; that it will afford a better navigation; that it will be adequate for all its uses for a longer time, and can be enlarged, if need should arise, with greater facility and less cost, we recommend the lock ca.n.a.l at elevation 85 for adoption by the United States.

The third report was made by the chief engineer, Mr. Stevens, who, quite apart from all considerations of expense, was strongly in favour of the high-level plan.

The three reports were considered by the ca.n.a.l commissioners, a majority of whom ultimately agreed with the minority of the advisory board. They admitted that a sea-level ca.n.a.l was ideally the best, but considered that the cost of making such a ca.n.a.l sufficiently wide would be prohibitive. They declared therefore for a lock ca.n.a.l at an elevation of 85 feet above sea-level. They gave their decision thus:--

It appears that the ca.n.a.l proposed by the minority of the board of consulting engineers can be built in half the time and at a little more than half the cost of the ca.n.a.l proposed by the majority of the board, and that when completed it will be a better ca.n.a.l, for the following reasons:

1. It provides greater safety for ships and less danger of interruption to traffic by reason of its wider and deeper channels.

2. It provides quicker pa.s.sage across the isthmus for large ships or a large traffic.

3. It is in much less danger of damage to itself or of delays to ships from the flood-waters of the Chagres and other streams.

4. Its cost of operation and maintenance, including fixed charges, will be less by some $2,000,000 or more per annum.

5. It can be enlarged hereafter much more easily and cheaply than can a sea-level ca.n.a.l.

6. Its military defence can be effected with as little or perhaps less difficulty than the sea-level ca.n.a.l.

7. It is our opinion that the plan proposed by the minority of the board of consulting engineers is a most satisfactory solution of an isthmian ca.n.a.l, and therefore we recommend that the plan of the minority be adopted.

In February 1906 the president referred the question for final decision to Congress. In his message on the subject he spoke thus:--

It must be borne in mind that there is no question of building what has been picturesquely termed "the Straits of Panama"--that is, a waterway through which the largest vessels could go with safety at uninterrupted high speed.

Both the sea-level ca.n.a.l and the proposed lock ca.n.a.l would be too narrow and shallow to be called with any truthfulness a strait, or to have any of the properties of a wide, deep water strip. Both of them would be ca.n.a.ls, pure and simple.

Each type has certain disadvantages and certain advantages.

But, in my judgment, the disadvantages are fewer and the advantages very much greater in the case of a lock ca.n.a.l substantially as proposed in the papers forwarded herewith; and a careful study of the reports seems to establish a strong probability that the following are the facts: The sea-level ca.n.a.l would be slightly less exposed to damage in the event of war; the running expenses, apart from the heavy cost of interest on the amount employed to build it, would be less; and for small ships the time of transit would probably be less. On the other hand, the lock ca.n.a.l, at a level of 80 feet or thereabouts, would not cost much more than half as much to build, and could be built in about half the time, while there would be very much less risk connected with building it, and for large ships the transit would be quicker; while, taking into account the interest on the amount saved in building, the actual cost of maintenance would be less. After being built, it would be easier to enlarge the lock ca.n.a.l than the sea-level ca.n.a.l.

The law now on our statute books seems to contemplate a lock ca.n.a.l. In my judgment a lock ca.n.a.l as herein recommended is advisable. If the Congress directs that a sea-level ca.n.a.l be constructed, its direction will, of course, be carried out.

Otherwise, the ca.n.a.l will be built on substantially the plan for a lock ca.n.a.l outlined in the accompanying papers, such changes being made, of course, as may be found actually necessary.

In June 1906 Congress finally decided for a high-level ca.n.a.l, and the controversy was officially closed. But the friends of the sea-level scheme were by no means silenced. Whenever any serious difficulty occurred in the construction of the ca.n.a.l on the lock principle their voices were heard again. In fact, the conflict cannot be said to have ended until 1909, and even then it is not certain that the sea-levellers modified their convictions.

CHAPTER IX.

MAN AND THE GNAT.

Almost at the beginning of their great task the Americans were faced with a problem which involved the success or failure of the whole enterprise. I have said something about the climate and health conditions at the isthmus. It is fairly certain that yellow fever and malaria would have wrecked the French undertaking even if there had been no other obstacles to its success. It is not less probable that if the Americans had been in no better a position to wage war with these plagues, their work at the isthmus would also have been in vain. The French had built excellent hospitals and provided efficiently for the comfort and recovery of those who were stricken with these diseases. But being totally ignorant of the sources and method of transmission of malaria and yellow fever, they could do nothing effectual in the way of prevention and eradication. They could only take the individual victim when they found him and do their best to cure him. They still believed that malaria was produced by climatic conditions, by marshy emanations, mists, and so forth. The fleecy clouds which gather round the isthmian hills in the rainy season were given the very undeserved t.i.tle of "the white death" by the French workers at the isthmus. Yellow fever, again, was just as mistakenly attributed to the climate, and especially to filthy ways of living. It is not surprising that, with these misconceptions, medical skill should have been almost useless during the French occupation, and that the employees at the isthmus should have died in their thousands.

But since the days of the Lesseps company, science had thrown a flood of light on the nature of these tropical scourges and the secret of their transmission. As these medical and scientific pioneers made a Panama Ca.n.a.l possible, though their names are not directly linked with its construction, we may look back for a few moments at their triumphs of discovery. The credit for first discovering that malaria is not due to poisonous emanations or contagion but is carried from people infected with the disease by the _anopheles_ mosquito belongs to Major (now Sir) Ronald Ross, formerly of the Indian Medical Service, who devoted himself to this subject during the last years of the 19th century. By a series of experiments he proved that malaria is due to the presence in the human blood of an organism which is conveyed from person to person by this mosquito, and that the mosquito is harmless unless it has become infected with the germ by biting a person who has caught malaria. The value of this discovery was soon shown by practical applications. Major Ross was engaged by the Suez Ca.n.a.l Company to deal with the malaria which had become firmly established at Ismailia, a little town of 10,000 inhabitants on that ca.n.a.l. No fewer than 2,500 cases had been supplied in one year by this small population. The new methods founded on the new discovery proved so effectual that in three years the disease was stamped out, and there has been no relapse ever since. The same results were achieved at Port Said.

Now, if malaria is thus caused by mosquito bite, there was some _a priori_ reason for thinking that yellow fever might be transmitted in the same way. At any rate the insect was again laid under a very grave suspicion. The opportunity for studying this further question was afforded during the Spanish-American war, when a serious outbreak occurred among the troops occupying Havana, in Cuba. The doctors were quite unable to deal with this most terrible of all diseases. Knowing nothing whatever of its cause, their treatment of it could be only experimental and casual. So a board of inquiry was formed consisting of four army surgeons serving in Cuba--Walter Reed, James Carroll, Jesse W.

Lazear, and Aristides Agramonte. The experiments were begun in June 1900, and continued into the next year. Of these four, Dr. Agramonte was not liable to the disease, and Dr. Reed was called away on duty to Washington. The other two determined to experiment on their own persons rather than risk the lives of other people.

Dr. Carroll first allowed himself to be bitten by the mosquitoes, not the _anopheles_ but another variety known as the _stegomyia_. He fell ill with a bad attack of yellow fever, which very nearly cost him his life. Later, in the yellow fever hospital, Dr. Lazear deliberately allowed a mosquito to feed on his hand. In four days he was down with the disease in so acute a form that he died of it--a true martyr, if ever there was, to the cause of science and the welfare of mankind.

These and other experiments proved conclusively that yellow fever, like malaria, is transmitted by mosquito bites, but it was still uncertain how soon after biting an infected person the mosquito becomes itself harmful and how soon a person stricken with malaria is able to infect a healthy mosquito. So further experiments were necessary, and volunteers were invited to offer themselves for this service. Everybody in the army knew what had happened to Doctors Carroll and Lazear, but in spite of this plenty of willing martyrs appeared. The first to present themselves were two young soldiers from Ohio, John R. Kissinger and John J. Moran.

Dr. Reed talked the matter over with them, explaining fully the danger and suffering involved, and stating the money consideration offered by General Wood. Both young men declared that they were prepared to undergo the experiment, but only on condition that they should receive no pecuniary reward. When he heard this declaration, Dr. Reed touched his hat with profound respect, saying, "Gentlemen, I salute you!"[8]

Kissinger took the disease from the mosquito bites, and recovered. A room was prepared for Moran, a sort of mosquito den into which fifteen gnats, all suffering from yellow fever, had been admitted. Major Reed describes what happened:--

At noon on the same day, five minutes after the mosquitoes had been placed therein, a plucky Ohio boy, Moran by name, clad only in his night-shirt and fresh from a bath, entered the room containing the mosquitoes, where he lay down for a period of thirty minutes. Within two minutes of Moran's entrance he was being bitten about the face and hands by the insects, that had promptly settled down upon him. Seven, in all, bit him at this visit. At 4.30 p.m. the same day, he again entered and remained twenty minutes, during which time five others bit him. The following day, at 4.30 p.m., he again entered and remained fifteen minutes, during which time three insects bit him; making the number fifteen that had fed at these three visits. On Christmas morning, at 11 a.m., this brave lad was stricken with yellow fever, and had a sharp attack, which he bore without a murmur.

But still the demonstration was not complete. It was necessary to prove by equally undeniable evidence that yellow fever is not conveyed by contagion with the clothes and persons of infected people. These experiments were even more trying and heroic than those which preceded.

A small wooden hut, 14 by 20 feet, was prepared, and into this was stored a large amount of bedding and clothes which had been used and worn by persons suffering from the fever. The building was carefully guarded against the intrusion of mosquitoes, and a temperature of seventy-six degrees, with a sufficient moisture, maintained. For twenty consecutive days Dr. Clarke and his men went into this room, handled, wore, and slept in the contaminated clothing, although the stench was so offensive as to be almost appalling. They emerged from the ordeal in perfect health, proving beyond possibility of dispute that the disease was not contagious, and that the mosquito was the sole method of transmission.

When distributing the credit for the new channel of world-traffic through the isthmus of Panama, let us not forget Dr. Lazear who sacrificed his life and the many others who cheerfully risked their lives to establish truths and facts without which the construction and continued operation of the ca.n.a.l would almost certainly have been impossible.

One mosquito may look very much like another, but the _stegomyia_ and the _anopheles_ differ in many important respects. The latter finds its most favourable breeding-places in stagnant pools of fresh water, such as are left by the heavy rains of the isthmus. It is essentially a gnat of the country-side. The _stegomyia_, on the other hand, inclines to a more frivolous town life. Cisterns and tanks and other receptacles for storing water are his favourite haunts. In length of life and power of flight the species also differ, though these details are not yet fully ascertained. The _stegomyia_ is said to live three months. Dr. Cornish states that it becomes dangerous only by attacking man during the first three days of yellow fever, and that, even then, twelve days elapse before its bite is infectious. Six days after a man has been bitten by an infected _stegomyia_ he falls ill with yellow fever, and for the next three days he is capable of transmitting it to the healthy mosquito. Mr.

Bishop informs us that if there is no fresh case of yellow fever within a period of sixty days after the latest one in an epidemic, it is a safe conclusion that the disease has been stamped out, because there is no mosquito alive to carry the parasite. After a period of ninety days all doubt on the subject is removed.[9] If a community, therefore, which has thus got rid of its last case of yellow fever could be completely isolated, yellow fever could never possibly return. It could only be reintroduced from outside. It should be possible, with a proper system of sanitation and quarantine, to free any district entirely from this awful scourge.

The case of the _anopheles_ and his little contribution to human suffering is very different. Whereas the victim of yellow fever either dies or gets better and quickly ceases to be a source of infection to the mosquito, the victim of malaria seldom dies of the disease, but he remains infectious to the _anopheles_ for three years. The disease does not simply attack new-comers or white people. Natives of the isthmus and the West Indies are subject to it, and, indeed, seem to be in a chronically malarious condition. It is said that 50 per cent. of the population of the isthmus were found in 1904-5 to have the parasite of malaria in their systems. It is difficult to estimate or imagine the part played by this widespread malady on conditions of life and civilization within the tropics.

Sir Ronald Ross, the greatest living authority on the subject, made some interesting remarks in an address at the Royal Colonial Inst.i.tute in January of this year. He said:--

Nothing has been more carefully studied of recent years than the existence of malaria amongst indigenous populations. It often affects every one of the children, probably kills a large proportion of the new-born infants, and renders the survivors ill for years; only a partial immunity in adult life relieves them of the incessant sickness. Here in Europe nearly all our children suffer from certain diseases--measles, scarlatina, and so on. But these maladies are short and slight compared with the enduring infection of malaria. When I was studying malaria in Greece in 1906, I was struck with the impossibility of conceiving that the people who are now intensely afflicted with malaria could be like the ancient Greeks who did so much for the world; and I therefore suggested the hypothesis that malaria could only have entered Greece at about the time of the great Persian wars. One can scarcely imagine that the physically fine race and the magnificent athletes figured in Greek sculpture could ever have spent a malarious and splenomegalous childhood. And, conversely, it is difficult to imagine that many of the malarious natives in the tropics will ever rise to any great height of civilization while that disease endures amongst them. I am aware that Africa has produced some magnificent races, such as those of the Zulus and Masai, but I have heard that the countries inhabited by them are not nearly so disease-ridden as many of the larger tracts. At all events, whatever may be the effect of a malarious childhood upon the physique of adult life, its effects on the mental development must certainly be very bad, while the disease always paralyzes the material prosperity of the country where it exists in an intense form.

The isthmus of Panama was beautifully adapted to the breeding of the _anopheles_ and the widest dissemination of malaria. In fact, the ca.n.a.l zone taken over by the Americans was perhaps the most malarial strip of territory in the world. The heavy rains leave the country covered with those marshes and pools from which these little ghostly insects are always rising in swarms, ready to carry the germs of disease from the sick to the healthy and thus perpetuate and extend the domain of this distressing malady. The reader will notice that, as the yellow fever victim is only infectious to the mosquito for three days, while the malarial person can convey the poison for three years, it is a much more practical problem to eradicate yellow fever than to stamp out malaria.

It is true the causes of malaria are now fully known and the only effective methods of propagation ascertained. If one could isolate all malarial patients, including all who are capable of transmitting the disease, in buildings screened with fine copper-gauze to keep out the mosquitoes and thus gradually diminish the area of infection to vanishing point, it would not be necessary to deal with the breeding-places of the mosquitoes, and man and the gnat might live together in perfect amity. But with fifty and even seventy per cent. of the people malarially infected, such a heroic course is obviously impossible, and one can hope only to diminish to a considerable degree the prevalence of the disease.

The first two and a half years of the American occupation of the isthmus was spent in looking round and preparing for the great work. It soon became evident that the most pressing and immediate task was one of cleaning up and sanitation. In July 1904, Colonel W. C. Gorgas, whose name will always be a.s.sociated with the triumphs won over disease at the isthmus, became the head of the department of sanitation under the Ca.n.a.l Commission. He quickly recognized that everything depended on the efficiency and success of his own department. "The experience of our predecessors," he wrote, "was ample to convince us that unless we could protect our force against yellow fever and malaria we would be unable to accomplish the work."[10] When the Americans took over, yellow fever, though present, was quiescent, but the figures began almost at once to mount up. In December 1904 there were six cases on the isthmus and one death. In January 1905 there were nineteen cases and eight deaths, seven and one respectively among the ca.n.a.l employees. In May there were thirty-three cases, twenty-two on the ca.n.a.l, with seven deaths in all, including three employees. In June there was an alarming advance.

Sixty-two cases occurred on the isthmus, thirty-four of them among the employees. There were nineteen deaths, six on the ca.n.a.l. Something like a panic then set in among the Americans engaged on the ca.n.a.l works. Many threw up their positions, and the homeward-bound steamers were filled with employees fleeing from this real "yellow peril." In the annual report of the Commission for 1905 we read:--

A feeling of alarm, almost amounting to panic, spread among the Americans on the isthmus. Many resigned their positions to return to the United States, while those who remained became possessed with a feeling of lethargy or fatalism, resulting from a conviction that no remedy existed for the peril. There was a disposition to partly ignore or openly condemn all preventive measures. The gravity of the crisis was apparent to all.

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