Since the later part of June, reports had been coming to headquarters of an extraordinary increase of sickness among the soldiers stationed at Pinar del Rio, the capital of the extreme western province, and very soon the great mortality from so-called "pernicious malarial fever" attracted the attention of the chief surgeon, Captain A. N. Stark, who, after consulting with Major Reed, ordered me to go there and investigate. A man had died, supposedly from malaria, just before my arrival on the afternoon of July 19. The autopsy which I performed at once showed me that yellow fever had been the cause of his death, and a search through the military hospital wards revealed the existence of several unrecognized cases being treated as malaria; a consultation held with the medical officer in charge showed me his absolute incapacity, as he was under the influence of opium most of the time (he committed suicide several months afterwards), and so I telegraphed the condition of things to headquarters; in answer I received the following: CHIEF SURGEON'S OFFICE, HDQRS. DEPT. HAVANA AND PINAR DEL RIO, QUEMADOS, CUBA, July 20, 1900 SURGEON AGRAMONTE, Pinar del Rio Barracks, Pinar del Rio, Cuba Report received last night. My thanks are due for your prompt action and confirmation of my suspicions. STARK, Chief Surgeon Conditions in the hospital were such as to demand immediate action; the commander of the post refused to believe he had yellow fever among his 900 men and was loath to abandon his comfortable quarters for the tent life in the woods that I earnestly recommended. In answer to my telegram asking for official support, I received the following: CHIEF SURGEON'S OFFICE, HDQRS. DEPT. HAVANA AND PINAR DEL RIO, QUEMADOS, CUBA, July 21, 1900 SURGEON AGRAMONTE, Pillar del Rio Barracks, Pinar del Rio, Cuba Take charge of cases. Reed goes on morning train. Wire for anything wanted. Nurses will be sent. Instructions wired commanding officer. Other doctors should not attend cases. Establish strict quarantine at hospital. You will be relieved as soon as an immune can be sent to replace you. Report daily by wire. STARK, Chief Surgeon