In all discussion with regard to canal construction at this time Nicaragua was looked upon as the point where the United States would build its canal. Delays entirely unexpected to the authorities occurred on account of the failure of the treaty with Colombia, and it was not until the fall of 1903 that it was settled that we were to build a canal at Panama, under a concession from the Republic of Panama. I was relieved from duty at Havana in the fall of 1902 and ordered to the United States, in order that I might be in personal contact with the preparations for canal work on the Isthmus. While waiting for the organization to commence, I was sent to Egypt as the representative of the Medical Department of the United States Army to the first Egyptian Medical Congress, and I was directed while on this duty to examine into what had been the sanitary conditions during the construction of the Suez Canal. This turned out to be a very interesting trip, though I did not get much information that was useful to us at Panama. The conditions were so entirely different at the Isthmus of Suez from the conditions at the Isthmus of Panama from a sanitary point of view that there was no similarity in the sanitary measures applicable to the two places. The route of the Suez Canal was through a dry, sandy desert, where, at the time of construction, they suffered from neither yellow fever nor malaria. The route of the Panama Canal lay through a low, swampy country, alternating with rugged mountainous regions, where the rainfall was excessive, and yellow fever and malaria prevailed to an alarming extent. During my visit there, however, I found that they were suffering severely from malaria at Ismalia, a town on the canal about half-way across the Isthmus, and the headquarters of the Canal Company. During the early period of their construction work they had a great deal of trouble supplying their laborers with drinking water. They were obliged to carry this on camel-back a number of miles from the nearest branch of the Nile. I was informed that, at one time, they had to employ some sixteen hundred camels in this work.