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CHAPTER SEVENTEEN

YELLOW JACK

The American doctors and sanitary inspectors had arrived in Panama full of confidence. They might have felt underappreciated by the engineers among the first arrivals, but they were sure they had the knowledge and experience to rid the Isthmus of disease-carrying mosquitoes. Before departing for the tropics Gorgas and Le Prince had met a senior U.S. entomologist, who had asked them to send back samples of Panamanian mosquitoes. “I will have to do it soon, Doctor,” Le Prince had exclaimed, “for in a year or so there will be no mosquitoes there!”

Gorgas had been to Paris to study the medical records of the French companies. He knew the story of the Dingler family, of the massive losses and demoralization from disease during the 1880s. But he was not downhearted, as he was aware that the Americans had a crucial advantage over de Lesseps's men. For between the time of the French on the Isthmus and the start of the American canal effort, a massive advance had occurred in the control of malaria, and, even more so, yellow fever: the miracle of Havana.

As in the fields of technology and engineering, the twenty years after the beginning of the French canal saw astounding advances in medical science. In 1880 the germ theory of disease—pioneered by Pasteur, Koch, and Lister—was still the subject of debate in the medical profession and derision by the public. But by 1900 a revolution had occurred. The new world discovered under the microscope had ushered in fresh understanding of diseases that had baffled man for centuries. For the U.S. effort in Panama no advance was more important than the understanding of the mosquito transmission of malaria and yellow fever.

The entire idea of an insect vector was quite new. In 1878 a Scottish doctor, Patrick Manson, working in southern China, had discovered that mosquitoes carried the developmental stage of a parasitic worm that caused elephantiasis. It was the first proof that a bloodsucking insect could harbor, and presumably transmit, organisms of human disease. Then in 1881, in Havana, the Western Hemisphere's “yellow jack” capital, an article was published in a medical journal that not only identified the mosquito as the yellow fever's carrier, but also the particular species, Aïdes aegypti. Its author was French-Scottish doctor Carlos Finlay, who had worked in Cuba for twenty years. He had studied the literature of yellow fever epidemics and had noted that they all mentioned the unusually high prevalence of mosquitoes. He then identified the particular species by analyzing the factors the sites of the epidemics had in common—temperature, elevation above sea level—and matching them to a mosquito that thrived only in these conditions.

But the theory—with hindsight a stroke of genius—was either ignored or ridiculed. The problem was not just resistance to a new idea; Finlay himself carried out numerous experiments the results of which seemed to disprove his own theory. Countless times he attempted to infect a patient using a mosquito that had bitten someone with yellow fever, but no one ever got ill as a result. Finlay, soon disparagingly known as “the Mosquito Man,” was written off as a crank.

More than fifteen years later, by which time the Isthmian mosquito had seen off de Lesseps and his French canal dream, an obscure English army physician, Ronald Ross, stationed at a remote field hospital in India, worked out the life cycle of the malaria parasite. In the summer of 1897 he dissected an Anopheles mosquito that was known to have bitten a malaria sufferer. Under a microscope he found in the insect's stomach the same circular cells identified as the malaria parasite Plasmodium falciparum by a French doctor Alphonse Laveran, in Algeria in 1880. The following year Ross located the mosquito's salivary gland and found the parasite there, confirming that the insect vector passed the disease on with a subsequent bite. Thus to control the disease, which at the time took a million lives a year in India, it was necessary to prevent mosquitoes biting an infected patient as well as keeping them away from healthy humans.

In the same year, 1898, Henry Rose Carter, a maritime doctor with experience of yellow fever quarantines, made an observation that offered to come to the rescue of old Dr. Finlay's theory. While working in a small Mississippi town during an outbreak of yellow fever, he noticed a strange pattern: there was usually a period of twelve days to three weeks between the appearance of the first case of yellow fever in a community, and subsequent cases apparently derived from it. This led him to carry out case studies on dwellings where a patient had become infected. By carefully noting visitors to the house, he established that those who came in the first two weeks were fine, but thereafter, and even when the original patient was removed, there was a risk of infection. Not only did this point to an insect vector, but it also established that the virus needed a period of “extrinsic incubation” inside the mosquito before it became dangerous. This neatly explained the failure of Finlay's experiments.

After the end of fighting in Cuba in August 1898, some fifty thousand U.S. military remained on the island for “pacification.” Their continued losses from disease highlighted the fact that yellow fever probably presented the single greatest threat to U.S. expansion in the tropics. For almost everyone there was little doubt as to what was to blame—the filthy streets of Havana. In January 1899, William Crawford Gorgas, who had worked in a yellow fever camp during the war, was charged with cleaning up the city.

Gorgas, the son of a Confederate general, had become a doctor as the only way to secure an army commission after his rejection by West Point. Posted all around the frontier areas of the United States, Gorgas was on the Río Grande near the border of Mexico in August 1882. It was, wrote his wife whom he met that year, “yellow fever's first encounter with one who became its implacable foe, and whose life was to be concentrated on its extermination.” Gorgas caught the disease but survived and was therefore subsequently immune. Thereafter yellow fever epidemics became his specialty.

But for now, Gorgas was firmly with the majority about the cause of the disease: rotting rubbish and filth, together with “fomites”— everything the patient had touched while infected. Gorgas met and befriended Finlay in Havana but, he later wrote, “we were rather inclined to make light of his ideas, and none more so than I.”

Backed to the hilt by the city's military governor, he went to work. Streets were swept clear of dead animals and rubbish. Every house was cleaned and disinfected with “chlorinated lime,” essentially bleach. The exhaustive sanitation campaign was closely followed by the U.S. press. With plenty of “before and after” pictures the work made good copy and showed the American intervention in a good light. The cleanup also slashed the previously high rates of illnesses such as typhoid and dysentery. Furthermore, the yellow fever epidemic of the previous year showed no signs of returning.

But in August 1899 some 12,000 nonimmune Spanish workers arrived on the island. Within weeks yellow fever was back. It seemed that all Gorgas's hard work had not made the slightest difference. Worst of all, the disease seemed to hit hardest in the smarter “expatriate” areas of Havana (where, of course, the highest proportion of nonimmunes were living). The deaths of high-profile members of the U.S. community caused widespread panic.

Governor Leonard Wood ordered Gorgas to redouble his sanitation effort and made $50,000 available for the purpose. But the renewed round of sweeping and scrubbing had no effect. It was time for a new approach.

In June 1900, a special Yellow Fever Commission was appointed by Washington. Dr. Walter Reed, an expert bacteriologist as well as an experienced “frontier doctor” like Gorgas, was in charge, assisted by Drs. James Carroll, Aristides Agramonte, and Jesse W Lazear.

Reed seems to have landed in Havana with an open mind, amenable to persuasion by observed fact. The questions facing the Commission were simple: What agent causes yellow fever? How is it spread? How can it be stopped? On the first of these, the doctors drew a blank early on. They looked through the microscope at the blood of yellow fever patients but could not find the “germ” or “bacteria.” Viruses, of course, were unseen and unknown in 1900. On the second question, however, there was an early breakthrough. Soon after his arrival Reed was presented with a curious case. A soldier at the nearby military base had been locked in a cell following a disciplinary infringement. A month after having been imprisoned, he had come down with yellow fever and died six days later. But none of his eight cellmates had contracted the disease, even the one who had subsequently slept in the dead man's bunk. The men had remained sealed in the cell, but it did have a window. Reed concluded that something must have carried the infection in through the window, passed it to a single subject, and then departed: it had to be an insect.

The Commission turned to Doctor Finlay, whose theories were suddenly in favor at last. Finlay was happy to provide Jëdes aegypti eggs so that specimens could be bred for experiments. While several of the doctors tried to find out all they could about the insect's habits and life cycle, others attempted to achieve the demonstration of the theory that Finlay's experiments had failed to provide. For this volunteers were needed who were prepared to be bitten by infected insects. Although those selected would, of course, be the strongest and healthiest specimens, and the best care available would be ready for them, they would still run a heavy risk of death. Five hundred dollars was offered as an incentive, although the first U.S. Army volunteers nobly refused the reward, setting a precedent that was followed throughout the experiments. Reed's team of doctors also subjected themselves to the same tests.

Early results were disappointing, but after belatedly taking into account Carter's findings on “extrinsic incubation,” yellow fever was successfully transferred from one patient to another. Along the way both Carroll and Lazear became infected. Carroll narrowly survived, but Lazear, with what Gorgas called the worst case of yellow fever he had ever seen, died an agonizing death on September 25.

Reed was much chastened by the gruesome sacrifice of Lazear, a hugely popular member of the team, but was convinced that his experiments had yielded up yellow fever's secret. However, when Reed presented the mosquito theory to a Public Health Association meeting in Minneapolis in November 1900 he was greeted by a stony silence, followed by scathing criticism. The Washington Post was condemning in its report of the new theory: “Of all the silly and nonsensical rigmarole about yellow fever that has yet found its way into print—and there has been enough of it to load a fleet—the silliest beyond compare is to be found in the mosquito hypothesis.” The centuries-old, “common-sense” theory that yellow fever was caused by dirt was not to be moved.

Reed returned to Havana and set up a new base, named Camp Lazear, in an isolated spot outside Havana. Here it was possible to achieve a far higher level of control and scientific rigor over experiments. Reed was determined to provide data that even the most diehard believer in the filth theory would have to accept. At the end of November an experiment was started wherein a doctor and three volunteer soldiers were confined for twenty days to a mosquito-proof wooden shack. Inside, they slept on the soiled and vomito negro— plastered bedding of previous yellow fever victims. No one got ill, and the “fomites” theory, which had governed quarantine law for centuries, was demolished forever.

Other meticulous tests demonstrated again that Aëdes aegypti was the vector of the disease, but there remained doubters. One was Gorgas himself. Even if the insect did spread the disease, what was to say that this was the sole method of transmission, or even the most common one? The only way to demonstrate the theory for sure was to take it out into the field: to get Gorgas's sanitation squads to destroy the A¨des aegypti of Havana and see what happened.

This Herculean task was something of a last resort. But tests with inoculations had ended when a young American nurse died from her injection, and to screen all yellow fever patients—to keep the mosquitoes from becoming infected—was impossible as many cases went unreported. Therefore the only option left was to take on the mosquitoes themselves.

Called the “aristocrat of mosquitoes,” A¨des aegypti is distinctly marked. Its body has a series of silvery half moons, its legs are alternately black and white, and it has four brilliant stripes on its thorax. Only the female of the species is a bloodsucker—she needs blood to mature her eggs—and she has a marked preference for human blood to the extent that she knows where to attack a person: under the wrist or on the ankles, where the skin is thinnest, and never on the face or top of the hand as these places are easily slapped. Also, she is only very rarely found away from human habitation and always lays her eggs near a ready supply of human blood.

The researchers in Havana also discovered that she is very meticulous, preferring to lay her eggs in clean water in man-made containers, such as earthenware jugs or water butts. And this, they concluded, was her great weakness. So when Gorgas went to work in February 1901 on his new campaign directed entirely against A¨des aegypti, he started by directing that all such containers should be removed or screened. Where this was impossible, a layer of oil was poured on the surface of the water to suffocate any larvae, or “wrigglers” as they were commonly known, that might be lurking inside. At the same time, the entire city was divided into districts and meticulously fumigated by burning sulphur or pyrethrum, a dried flower used as an insecticide. The results were truly spectacular—a dramatic reduction in yellow fever from 1,400 known cases in 1900, to only 37 in 1901, none of them after October. The eradication procedures didn't just kill off Aêdes aegypti, but reduced the Anopheles population as well, thus decreasing malaria cases by more than half.

Havana had suffered some five hundred deaths a year from yellow fever for as long as anyone could remember. Now, quite suddenly, it was over. Furthermore, a controversial and important new theory had been proved correct, and the methods selected to exterminate the disease vector had worked. When the scale of the triumph began to sink in, Gorgas wrote to Reed, “When I think of the absence of yellow fever from Havana for a period of fifty days, I begin to feel like rejoicing that I was ever born!”

All of this hard-won knowledge and expertise was brought by Gorgas to his task in Panama. Indeed, most of the doctors who arrived with him in June 1904 were also veterans of the miracle in Havana. Yet by September, Gorgas would be utterly frustrated, despondent, and full of dread. “The Commission have their own ideas about sanitation, and do not seem much impressed with mine,” he wrote. Gorgas accurately predicted what was to come: “I fear an epidemic is inevitable. If only we could convince them! If only they knew!”

orgas had been confronted by many medical challenges at the start of the American effort in Panama. On his reconnaissance mission in April 1904 he had noted the filthy streets and the extraordinary prevalence of malaria. But he had selected yellow fever as the first of his enemies to be attacked. For a start, the defeat of the disease was an achievable goal; Gorgas had demonstrated in Havana that a spectacular and very press-friendly victory could be won. He had also seen enough yellow fever epidemics to know the disproportionate panic they could cause and how they were ignited by an influx of nonimmune personnel, just as was about to happen in Panama. Furthermore, yellow fever attacked the bosses and spared the workers, affecting in the main white outsiders, perceived to be the most valuable and least expendable of the canal workers. The health of this group would remain Gorgas's top priority. Writing in an American medical journal in 1909, and sounding more than a little like Alfred Mahan, he boasted, “our work in Cuba and Panama will be looked upon as the earliest demonstration that the white man could flourish in the tropics and as the starting point of the effective settlement of these regions by the Caucasian.”

Gorgas got to work within two weeks of his arrival, dividing Panama City up into districts and beginning house-to-house inspections, as he had done in Havana. But from the very start his efforts were severely hampered. The problem was that the gentlemen of the Commission simply did not believe the mosquito theory. The year before, a scientific congress in Paris had reviewed Reed's yellow fever work and proclaimed it “scientifically determined fact,” and Ronald Ross had received a Nobel Prize for his work on the mosquito transmission of malaria. Ross even visited Panama in mid-1904 and pronounced Gorgas's plans sound. Nevertheless, to Walker, the theory was “the veriest balderdash.” Gorgas should concentrate on cleaning up the filth and smells, the chairman of the Commission pronounced. The Zone governor, General Davis, concurred, saying to the doctor in a fatherly tone, “I'm your friend, Gorgas, and I'm trying to set you right. On the mosquito you are simply wild. All who agree with you are wild. Get the idea out of your head. Yellow fever, as we all know, is caused by filth.”

Ross himself wrote, “The world requires at least ten years to understand a new idea, however important or simple it may be.” Nevertheless, it is not hard to sympathize with Gorgas's frustration. Wallace was no better, sounding like old Jules Dingler when he announced that “clean, healthy, moral Americans” would not contract the disease.

So the Commission believed that Gorgas's efforts were a waste of time and money, and his requisitions for supplies suffered even worse than anyone else's, despite Roosevelt's express order that the medical effort be given top priority. Vital copper screening and medical supplies ordered in October 1904 had still not arrived the following April. Gorgas's department was also given the workers that no one else wanted and ordered to pay the lowest wages. “Consequently,” Joseph Le Prince complains, “only poor and unintelligent labour could be obtained … some of them could not even climb a ladder. This was the only class of labor allowed the sanitary department. We had to use it, and succeed or fail.”

The fumigation squad visited Claude Mallet's house on July 27, 1904. His rooms were swept clean and his yard cleared of anything that might hold water. His tanks were covered with wire netting and taps installed, and he was shown how to pour oil on the surface of the water. He was pleased with the result, writing to his wife that he was now able to read “without having to wipe the mosquitoes off every second,” and pronounced himself “a convert to the mosquito theory.” But he also reported the more than slightly haphazard way in which the house was fumigated—windows and doors were left open—and that Aêdes aegypti larvae were still found in his water tanks on another inspection a week later.

Gorgas had taken on a huge task. Unlike in Havana, in Panama mosquitoes bred all year round. The first inspection showed Aëdes aegyfitilarvae “existed at practically every house in town.” There was no running water, and, with ice expensive, locals cooled water by keeping a supply indoors in earthenware vessels, called tinajas. “In these,” reported Joseph Le Prince, “larvae thrived in great numbers.” Gorgas simply did not have sufficient men and materials to carry out the job as thoroughly as required.

Some Panama City residents like Mallet welcomed the chance to have their homes cleaned out at the expense of the U.S. government. The British consul even tried to get the gang to paint his house while they were about it. But the measure was not compulsory. At the beginning of July a fine of five dollars was introduced for anyone who bred larvae in their house, but there were hardly any prosecutions, and usually tenants simply emptied water vessels at the back door while the inspector was entering at the front. Alternatively, the offending containers were hidden away. As most Panamanians were immune to yellow fever, they felt little compulsion to assist in the eradication program, and many did not believe it was possible anyway. “To attempt it is a dream, an illusion, perhaps simply a case of American boasting,” wrote the local Liberal newspaper, the Diaro de Panama. It was very different from Havana, where Gorgas's squads had had a sympathetic governor and martial law to back them up.

Not that the Americans, who were most at risk, were much more helpful. Visits to Panama City were strongly discouraged, but this was widely ignored, particularly after the banning of gambling in the Zone in August 1904 and the subsequent steep reduction in liquor licenses. Most of the United States personnel on the ground shared the Commission's skepticism about the mosquito theory. A particular concern of the Sanitary Department was the Administration Building, where some three hundred nonimmunes, mostly young Americans, were working. Screen doors were left propped open, and many rooms were unscreened altogether. But when Joseph Le Prince pointed this out to Wallace's nephew O. M. Johnson, the young supervising architect, and alerted him to the fact that the bowls of water used to dampen the architects’ copying brushes were ideal places for mosquitoes to breed in, he was laughed at. “Le Prince,” Johnson said, “you're off on the upper story!”

“But suppose,” the inspector argued, “we have twenty deaths here. Who'll be responsible?”

The architect laughed. “I'll stand the responsibility,” he said.

The yellow fever onslaught, as predicted by Gorgas, began at the end of the year. In November an unemployed Italian laborer was brought into the San Tomás hospital in Panama City with a serious case of the disease. He survived, but then news came that two other Italians, members of an opera troupe that had been touring the line of the works, had died from yellow fever on the boat home. The following month Gorgas was forced to suspend his fumigation program in Panama City due to lack of supplies, and six new cases emerged, several from the areas left untreated. “Some yellow fever cases exist in the San Tomas hospital and the Yankees are much scared,” wrote Mallet to his wife. Indeed, with the first yellow fever death in December, the Americans were getting jittery. In August, U.S. minister John Barrett had been making plans to bring his mother to live with him in Panama. But on December 20 he wrote to her that he had changed his mind: “If you should be unwell here or if anything should happen to you I could never forgive myself for bringing you to Panama.” Wallace tried to calm the workforce by ostentatiously riding around town in the company of his wife, newly arrived from the United States. But his efforts were undermined when it became known that the couple, fearing the worst, had imported two smart metal coffins. The sense of impending doom deepened with the appearance in mid-January of six cases on the U.S. cruiser the Boston, anchored in Panama Bay. An inspection “revealed a dishpan of water standing outside the cook's headquarters. The thing was so thick with mosquito larvae that it was practically a purée.” On January 16 the recently arrived young wife of Wallace's secretary John Seager died after a short and very sharp attack of the disease. She had only been married for two months and her death caused deep shock to the expatriate community. Governor Davis called it “the saddest incident in the history of the American colony … I attended the funeral this afternoon in the chapel of the Hospital, and as I looked at young Seager overcome with grief at the loss of his wife, I had great difficulty in restraining sympathetic tears. Nearly all the eyes in the room were moist… Naturally this death among those that are so well known has almost caused a panic in the ranks of the American employees of the Canal Commission.” There were further high-profile deaths, and by the end of January, after nearly twenty cases had been identified that month, it was clear that an epidemic was under way. “How glad I am that I did not bring you down to Panama,” Barrett wrote to his mother on January 30. “With malaria and yellow fever rife … not knowing who will be the next victim. I am glad that you are safe in ‘God's Country’… About the only subject of conversation here in Panama is yellow fever.”

Everyone had seen the cemetery on the hill outside Colón, “one of the saddest graveyards in the world, acres of little white crosses falling over and rotting under the jungle of tropical growth.” Now the shadow of Monkey Hill, where the dead from the French period lay buried, “darkened the whole Isthmus.” “The rush to get away,” wrote Gorgas's wife, Marie, now with him in Panama, “quickly assumed the proportions of a panic. The canal force—labourers, engineers and office men alike—seemed possessed of one single view: ‘Let's get out of this hell hole,’… and men arriving one day would take their departure the next, frequently on the same boat.” Inevitably the news of the exodus reached the United States, where a newspaper dubbed Panama “the place where the ‘ghost walks’… it seems that almost everybody is at a standstill down at Panama save the paymaster.” The Panama Star and Herald concurred: “Unless something is done and done quickly,” the paper wrote in late February, “all hopes of building a canal across the Isthmus of Panama may be set aside.”

t Ancón hospital cleaning and painting of the wards had, according to Eugenie Hibbard, “advanced quite rapidly.” The water guards around the bed legs were removed, and the grounds cleared, revealing the statues of saints scattered around the garden, previously hidden by dense undergrowth. The French nurses were shipped out as well. For all their compassion they were untrained and hindered in their effectiveness by the vows they had taken. Even if instructed not to feed men awaiting surgery, they would ignore the order as it went against their vow to give food to the sick. The nuns also had little time for the mosquito theory. American nurses would put mosquito nets in place around the beds at night, only to find in the morning that they had been tied back by the nuns with bows of brightly colored ribbon.

The hospital staff was suffering from the same frustrations as the rest of the sanitary department. The nurses complained about the poor salaries and lack of quarters. Jessie Murdoch was still having to sleep wrapped in citronella-soaked blankets to deter the mosquitoes. According to Hibbard, “In the early days the securing of absolutely necessary articles was difficult and tedious.” As everywhere on the Isthmus, she was forced to “make the best use of the materials left by the French.”

The beginning of the year saw a “steadily increasing number of patients.” The epidemic had spread from Panama City to Colón and along the line of the works. Soon two wards and several private rooms were given over to yellow fever patients. Each had a wire cage built around his or her bed to prevent them from infecting mosquitoes, and the wards themselves were protected by three screened doors, with pyrethrum powder burning continually between them and a guard outside to see that they were kept closed. With a tripling of yellow fever cases from December to January, “death seemed to dominate the situation,” Jessie Murdoch remembered, “almost causing panic … [yet] no one showed the white feather but all stood faithfully to their tasks.”

Then the epidemic stuttered: there were fewer cases in March than in February, and for the first two weeks of April there were none at all. On April 18 Gorgas wrote, for a piece to be published by Harper's Magazine, “I personally believe that we have seen the last case of yellow fever in Panama.”

The following day, Gorgas was summoned to the bedside of O. M. Johnson, the architect who had laughed at the warnings of sanitary inspector Joseph Le Prince. The symptoms—the headaches, back pain, terrible thirst, and then the vomito negro—were unmistakable. Gorgas personally supervised his care, but there was little he could do apart from make the patient as comfortable as possible. In the meantime, there was a stream of new yellow fever cases in the Administration Building. As Gorgas had feared, the disease had struck at the heart of the American project. In ten days, twenty-one cases were carried out of the U.S. canal headquarters. Johnson died on April 25 and was buried in one of the Wallaces’ metal coffins. It was, wrote Governor Davis, like “the ending of many a bright young man I have seen on the battlefield.”

But few of the Americans shared the martial, patriotic determination of the young French engineers twenty years earlier. “Everybody here seems to be sitting on a tack,” one engineer wrote home. When yet another case was announced in the Administration Building, a young stenographer “rose from his chair and shrieked, ‘I want you to understand now that if Tabor dies, I'm going home.’” Many were already on their way as “yellow fever … completely filled the atmosphere.” Panama City was abandoned as white Commission staff were moved out to Ancón Hill, but in less than two weeks two hundred resigned. One returning nurse told the New York Tribune that, bafflingly, yellow fever was even killing “well set-up, clean boys with good principles.” “We were taxed to the utmost in the effort to care for the sick and keep hope and encouragement alive,” writes Frank Maltby, who was still laboring away dredging the ends of the canal. It didn't help that Chief Engineer Wallace was off the Isthmus in Washington, pressing his case to be given more control over the project.

“Many resigned,” read that year's ICC annual report, “while those who remained became possessed with a feeling of lethargy or fatalism.” In all, some five hundred U.S. employees fled the Isthmus during April, May, and June 1905, about three-quarters of the white workforce after what was, in historical terms, a fairly mild flare-up of yellow fever. Amid the chaos came a reluctant reappraisal of the French effort, as, in the early summer of 1905, the work came to a virtual halt.

n Washington the wheels had been turning, albeit slowly. After his visit to Panama in November, Taft had reported to Roosevelt that the Commission under Walker and Davis seemed unwieldy and obstructive. As an engineer on the ground put it: “The military regime in Panama, in so far as the furtherance of engineering efficiency is concerned, is a failure; in so far as the maintenance of official orthodoxy is concerned, it is a great success.” This was backed up by Wallace, who requested that the Commission be reduced to three men: governor and chief engineer in Panama, with a chairman in Washington. In January the president requested that Congress amend the Spooner Act to make this possible, and the following month sent an eminent U.S. surgeon to investigate what was seen as Gorgas's failure to control disease on the Isthmus.

The surgeon, Dr. Charles A. L. Reed, toured the works during February, and his report was leaked to the U.S. press. One particular example he gave of the nightmare of red tape afflicting the medical department caught the eye and was reproduced across the country: a newborn baby needed a nursing bottle; the nurse applied to her superior, Major La Garde, who, finding the requisition of the previous September still unfulfilled, then made out another order, which had to be endorsed by Gorgas himself as well as the chief of the bureau for materials and supply, Mr. Tobey Then the order was copied and at last a messenger was permitted to go to a chemist and buy the nursing bottle, which finally reached the infant two days after the necessity for its use had arisen. The bottle should have cost no more than thirty cents, but counting the money value of the time of the nurse, of Major La Garde, of his clerical help, of Colonel Gorgas, of Mr. Tobey, of Mr. Tobey's clerks and of the messenger, the cost to the government of the United States, Reed calculated, was around $6.75. For all Walker's parsimony, it seemed the waste of the French canal period had never gone away.

Roosevelt was furious at the leak, but even angrier about the blow to the prestige of his canal project. When the Senate refused to agree to the change in the Commission, the president, acting by executive decree, demanded the resignation of Walker and his six colleagues. On April i he announced a new governing body for the canal, composed, as Wallace had suggested, of an executive committee of chief engineer, chairman, and governor, with four essentially sleeping partners added in to pretend compliance with the terms of the Spooner Act. Wallace, still highly thought of in the press, remained as chief engineer, and now had a seat on the Commission. Theodore Shonts, a “gruff, domineering” Pennsylvanian who had built, run, and owned a number of Midwestern railroads, was made chairman; and Charles Magoon the new governor. Magoon had made his name as a lawyer specializing in colonial administration and had served as legal counsel to the first Commission. He had helped Davis set up the Zone government, and had visited the Isthmus with Taft the previous November. While in Panama he had made a very favorable impression on the American chargé d'affaires William Sands, who had recommended him for the new dual role of governor and American minister to Panama.

Wallace was summoned to Washington for the first meeting of the new executive committee on April 10. Inevitably the recent yellow fever outbreak was discussed. It seems that there was little confidence in Gorgas. Shonts suggested that he be replaced with a friend of his, an osteopath with no experience of tropical medicine. Magoon agreed that a more “practical doctor” was required, one who would deal with the “smells and filth.” This suggestion was passed on to Taft, who approved it and sent it to the president.

But Roosevelt consulted medical authorities in the United States, all of whom backed Gorgas as the best man for the job. Finally the president sought the advice of a close friend and hunting companion, Dr. Alexander Lambert. The Commission and the secretary of war, Roosevelt told Lambert, were complaining that Gorgas spent all his time trying to kill mosquitoes while Colón and Panama were as dirty and stinking as ever. “Smells and filth, Mr. President,” Lambert replied, “have nothing to do with either malaria or yellow fever. You are facing one of the greatest decisions of your career. You must choose between Shonts and Gorgas. If you fall back on the old methods of sanitation, you will fail, just as the French failed. If you back up Gorgas and his ideas and let him pursue his campaign against the mosquitoes, you will get your canal.”

It was a bold step to go against the advice of his own Commission and secretary of war, but Roosevelt overruled their recommendation and ordered Magoon, who was about to leave for Panama, to give Gorgas all the backing he could.

Accompanied by Wallace, the new governor arrived at Colón on May 24, replacing Davis and Barrett, both of whom had already left the Isthmus, the former in the throes of severe malaria. Magoon was an immediate improvement on his predecessors. Sands described him as “huge in all three dimensions… and he had the gentle nature which so often accompanies vast bulk.” At 230 pounds, he was about as far from Roosevelt's vision of the new “strenuous” American as you could imagine. But he was immensely clubbable, from the very first ceremony in honor of his arrival, Magoon “displayed great interest in the people,” and, according to the Star and Herald, won the confidence of the Panamanians more than any other American had done so far. This helped immensely in his diplomatic task, defined by Sands as achieving “a truce among the personally jealous political leaders and between the racially hostile political parties long enough to get the Panamanian Republic in working order.”

In his role as governor of the Canal Zone, he had an even harder job ahead. Publicly he oozed confidence and optimism, but he reported in private that conditions were deplorable. Earlier that month the Star and Herald‘had written, “It would perhaps be difficult to find any spot on earth where discontent reigns so supreme as on the Isthmus of Panama.” Magoon wrote to Shonts back in Washington that he found the men working on the canal “ill-paid, over-worked, ill-housed, ill-fed, and subjected to the hazards of yellow fever, malarial fever,” and other diseases. Whatever exuberance had fired the first Americans in Panama, it was now long gone, replaced by bickering and demoralization.

One of Magoon's first acts was to listen to Gorgas about the problems he had been having with requisitions. The governor then cabled through to Washington the doctor's demands, and within forty-eight hours long-denied supplies were on their way. It looked as if Gorgas would at last have the tools he needed to complete the job. Magoon also made speeches promising that schools and churches would be built, and families encouraged to move out to the Isthmus.

Then, after only two weeks back in Panama, Wallace applied for urgent leave to attend to personal affairs in the United States. He also requested a private interview with Taft. Although Wallace had professed himself pleased with the recent changes to the Commission, it appears that it irked him that he had to answer to Shonts. He believed that the canal effort would be best served by concentrating all power in one man, namely himself. He also confided to Magoon that he had been offered a job with a salary of some $ 50,000 to 60,000 back in the United States. Wallace told Magoon that as he considered himself essential to the canal effort, he was going to try to squeeze Taft for a higher salary. In fact he wanted to be both chairman and chief engineer with the right to come and go between Washington and Panama as he wished. Failing this, he would be happy to leave the “godforsaken” yellow-fever-ridden Isthmus for good and take the money offered at home. All of this Magoon promptly cabled to Taft.

So the usually genial secretary of war was in a black temper when Wallace arrived to meet him at the Manhattan Hotel in New York on June 25. At the request of Taft, William Nelson Cromwell was present as a witness, much to Wallace's annoyance—one of the complaints he wanted to make was against the lawyer's disproportionate influence on canal affairs. Taft bluntly asked Wallace what could be so important to cause him to leave the Isthmus again at such a crucial time. Wallace replied that he wanted to resign as he had been offered another job with none of the risks of living in Panama. Perhaps Wallace expected Taft to offer him the top job to keep him in the organization, but if so he misjudged the secretary of war. Taft exploded: “For mere lucre you change your position overnight without thought of the embarrassing position in which you place your government by this action. By every principle of honour and duty you were bound to treat this subject differently… Great fame attached to your office, but also equal responsibility, and now you desert them in an hour … I am exceedingly sorry that you cannot see what a dreadful, dreadful mistake you are making. It pains me more than I can tell.” Wallace offered to stay on in some capacity to minimize the upset to the construction effort, but Taft ordered him to resign and have nothing more to do with the canal.

Wallace's resignation sparked fresh panic in Panama. “We felt like an army deserted by its general,” Frank Maltby would write. The rainy season had started, and yellow fever cases in June had nearly doubled over the month before. Men started frantically checking themselves every morning for signs of the illness. According to Marie Gorgas, “the effect [of Wallace's resignation] upon the workers at the Isthmus was deplorable. It seemed to inspire the labouring and the executive forces with one ambition: a determination to scuttle. There was only one reason why they did not get away en masse, and that was the lack of shipping space to carry them.”

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