Havana, Cuba, January 22, 1902. Major Walter Reed, Surgeon General’s Office, Washington, D. C. MY DEAR REED: Yours of January 14th received. The sending of clothing and bedding for disinfection to Las Animas, in yellow-fever cases, was stopped about (text missing). The official order was issued August 21, 1901. We have a large disinfecting plant at Las Animas to which everything of this kind is sent. When a house is disinfected for diphtheria or any similar disease, the room itself is infected with formaline gas and washed down with a bi-chloride solution “and all fabrics and clothing of every kind are sent to the disinfection plant”. Up to the time mentioned this had been done in the case of yellow fever, but, having become convinced that the mosquito was the only way of transmitting the disease and that no good could be obtained from this process, we stopped this method. From my experience here in municipal sanitation, I think this is of the greatest importance, viz: to put people to as little inconvenience and loss as possible by methods of disinfection. The destruction of mosquitoes in a building can be accomplished with very little annoyance to the inmates but the thorough destruction of fomites causes a great deal of inconvenience and some loss. The all important matter in yellow fever is to get your cases reported as thoroughly as possible and this can only be done with the co-operation of the people. I am therefore of the opinion that the great element of our success was due to the fact that we did away with the attempted destruction of fomites. You can readily see how one unreported case might start an epidemic. The Santiago de las Vegas case is a very good illustration of the efficiency of our methods in stamping out a focus. Santiago de las Vegas is practically a suburb of Havana, distant about twelve miles with a considerable non-immune population, constantly having communication with Havana. The infection of 1900 evidently remained over. Some cases occurred in January, some in June and more in July. The cases of July were taken and the houses all gone over, and the mosquitoes killed, but it was evident that the infection had gotten away from us by this method, so on the 24th of July we got a considerable appropriation and started a brigade systematically fumigating, block by block, around the infected areas. With this we were successful and got rid of the focus. This was the most difficult disinfection we have attempted. The infection had evidently got pretty widely spread and new cases kept occurring outside of the area in which we were working. I send you a few papers on the subject. Please return them when you have finished as they form a part of our records on the subject. Please excuse this hurried letter. Sincerely yours, W. C. GORGAS, Major and Surgeon, U. S. A. Chief Sanitary Officer. (16)