Yellow fever in Panama
Of all the scourges afflicting humans in Panama, none caused more fear than yellow fever. As soon as the first cases appeared, people fled in droves and took the first available ships to return home. Despite knowledge that the mosquito carried the disease, the old concept of miasmas or poisonous vapors emanating from swamps and wetlands surrounding populations, remained very much alive and hindered the Gorgas sanitation plan.
The first symptoms of yellow fever were back pain, headache and fever, followed by prostration, bleeding and decreased urine production. Finally, black vomit and delirium brought death within a few days to the unfortunate victims. No specific treatment was available for yellow fever but Gorgas claimed, based on his personal experience with more than a thousand cases, that his management of patients admitted to Ancon Hospital resulted in better survival rates. Treatment consisted of absolute bed rest, nothing by mouth except for sips of champagne and, rarely, administration of phenacetin for fever and pain.
Yellow fever patient in isolation cage. National Library of Medicine.
St. Charles Ward in Ancon Hospital, where more yellow fever patients died than anywhere else in the world. Mears J.E. The Triumph of American Medicine in the Construction of the Panama Canal, Philadelphia: Wm. J. Dornan, 1913.
Death of yellow fever at Ancon Hospital. Painting by Severino Baraldi, Look and Learn©, London.
Coffins at railroad station in Panama. Picture postcard, Bob Karrer Collection, Charlotte, South Carolina.
Mt. Hope Cemetery, Ancon, Panama. Picture postcard.
Yellow fever cases admitted to Ancon Hospital were registered in a logbook, including name, nationality, place of employment, date taken sick, date of admission and result (also date of death). A total of 246 cases of yellow fever were recorded over an 18-month period, case #1 entered on July 10, 1904, and the last case on November 22, 1905.
Yellow fever cases, Ancon Hospital logbook. Clendening History of Medicine Library and Museum, The University of Kansas Medical Center, Kansas City, Kansas 66160.
One day in September 1905, Gorgas entered a room while half-dozen white-clad figures were working hard over a cadaver of the last [yellow fever] victim. “Take a good look at this man, boys,” he said to the young surgeons, “for it’s the last case of yellow fever you will ever see. There will be no more deaths from this cause in Panama.” Except for a dubious case of jaundice reported in March 1906, Gorgas’ prophecy came true. Gorgas, Marie D. and Hendrick, Burton J., William Crawford Gorgas. His Life and Work, Philadephia: Lea & Febiger, 1924.