The Evolution of Modern Medicine: A Series of Lectures Delivered at Yale University on the Silliman Foundation in April, 1913Osler, William, Sir
History
The Evolution of Modern Medicine: A Series of Lectures Delivered at Yale University on the Silliman Foundation in April, 1913
Osler, William, Sir
Medicine -- History
Of the six important tropical diseases, plague, which reached the
Isthmus one year, was quickly held in check. Yellow fever, the most
dreaded of them all, never recurred. Beri-beri, which in 1906 caused
sixty-eight deaths, has gradually disappeared. The hookworm disease,
ankylostomiasis, has steadily decreased. From the very outset, malaria
has been taken as the measure of sanitary efficiency. Throughout the
French occupation it was the chief enemy to be considered, not only
because of its fatality, but on account of the prolonged incapacity
following infection. In 1906, out of every 1000 employees there were
admitted to the hospital from malaria 821; in 1907, 424; in 1908, 282;
in 1912, 110; in 1915, 51; in 1917, 14. The fatalities from the disease
have fallen from 233 in 1906 to 154 in 1907, to 73 in 1908 and to 7 in
1914. The death rate for malarial fever per 1000 population sank from
8.49 in 1906 to 0.11 in 1918. Dysentery, next to malaria the most
serious of the tropical diseases in the Zone, caused 69 deaths in 1906;
48 in 1907; in 1908, with nearly 44,000, only 16 deaths, and in 1914,
4.(*) But it is when the general figures are taken that we see the
extraordinary reduction that has taken place. Out of every 1000 engaged
in 1908 only a third of the number died that died in 1906, and half the
number that died in 1907.
(*) Figures for recent years supplied by editors.
In 1914, the death rate from disease among white males had fallen to
3.13 per thousand. The rate among the 2674 American women and children
connected with the Commission was only 9.72 per thousand. But by far the
most gratifying reduction is among the blacks, among whom the rate from
disease had fallen to the surprisingly low figure in 1912 of 8.77 per
thousand; in 1906 it was 47 per thousand. A remarkable result is that
in 1908 the combined tropical diseases--malaria, dysentery and
beri-beri--killed fewer than the two great killing diseases of the
temperate zone, pneumonia and tuberculosis--127 in one group and 137
in the other. The whole story is expressed in two words, EFFECTIVE
ORGANIZATION, and the special value of this experiment in sanitation is
that it has been made, and made successfully, in one of the great plague
spots of the world.
Public-domain text, read in full here on John Shaqi.
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