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dc.contributor.authorCarr, George Jamesonen
dc.date.accessioned2018-05-14T10:20:39Z
dc.date.available2018-05-14T10:20:39Z
dc.date.issued1940en
dc.identifier.urihttp://hdl.handle.net/1842/30087
dc.description.abstracten
dc.description.abstractA lack of imagination is at once one of the strengths and weaknesses of the British peoples. Disaster has often to be upon them before they can be aroused to take measures for defence, when by vision and forethought it could have been averted.en
dc.description.abstractOnly by such vision and action now, can the disaster be avoided which would follow the dis-organization of Sanitary Cordons inevitable in a World War.en
dc.description.abstractI had an opportunity of seeing this on a small scale during one of the revolutions in Brazil when non-immune troops were sent to the endemic areas of the North, in 1926.en
dc.description.abstractYellow Fever broke out among those troops, and panic ensued, although Brazil has been accustomed to that disease for hundreds of years.en
dc.description.abstractDuring 1925, when I was Director of the Yellow Fever Campaign in Parahyba do Notre in Brazil, Small -pox devastated the city, but that was taken calmly, as it was a regular occurrence, but, when a few cases of Yellow Fever were introduced from the outside into a city free of the vector, Aedes agypti, and therefore safe from spread, the panic was spectacular.en
dc.description.abstractThat was because everyone knew that the Authorities had, in vaccination, the means to check and prevent Small -pox, and that it was due to contact with humans, and willingly submitted to those Means. Yellow Fever, on the other hand, was a !MYSTERY" to superstitious people - and most people are - and considered as a Visitation.en
dc.description.abstractThe difference between the comparatively sparsely populated and immune Brazilian endemic area and the congested and absolutely non-immune tropical East, where the Aedes agypti is the common domestic mosquito and proved vector, is only one of degree, but of alarming magnitude.en
dc.description.abstractAgain, while the control of Aedes agypti is simple, and the method thoroughly understood and worked out over years, with complete success in the West, the East has much more complicated problems.en
dc.description.abstractThe ease of .cedes agypti control is due to its entirely domestic breeding habits, and control of the habits of the people as regards their water supply also controls the mosquito, but in the East there are other mosquitoes not domestic in their breeding habits but feeding avidly on humans, such as Aedes Albopictus, which can convey Yellow Fever, These mosquitoes breed in the jungle and plantation.en
dc.description.abstractIt is admitted that, as in the case of Malarial control, finance is paramount; this is the case also in Yellow Fever. The financial requirements of Yellow Fever control in an entirely Aedes agypti area, s in Brazil, being concomitant with the modern requirements of a pure water supply the expense is, in terms of control, within the sanitary budget.en
dc.description.abstractOn the other hand, the expense of controlling mosquitoes which breed outside houses on waste land as well as cultivated land would be prohibitive.en
dc.description.abstractIt is essential, therefore, that Yellow Fever never reaches the East.en
dc.description.abstractCarter, in his masterly work ''The Early History of Yellow Fever" (1931) , has shown how the disease came with the slave trade from the :'.rest Coast of Africa to the East Coast and Islands of the Central and South Americas. The wooden sailing ship of those days was ideal for the mosquito vector, and this manner of spread only ceased xith the change to metal ships.en
dc.description.abstractDuring the days of slot' sail the mosquito was the factor that mattered because, once infected, it could remain alive long enough to infect humans on arrival at the other side, without the necessity of transference through man. This will be explained in detail in another section. Now we have both fast water, and still faster air transport. I well remember my thoughts when, at Pernambuco in February 1926, I saw Major Franco, the Spanish Aviator, land from Dakar in the first flight across the Southern Atlantic. Before, the insect alone ,could come, or, as was more usual, man and insect came together, for man alone would have been dead or recovered in the time necessary to make the crossing; now, as a result of air travel, either or both could come alone or together.en
dc.description.abstractFour years later, although only eight transSouth Atlantic flights had been made, my forebodings' were unhappily proved right, by the discovery of A.gambiae in the town of Natal after a severe outbreak of Malaria. This mosquito, the common vector in Africa, had never before been in America and the town of Natal had never before had an epidemic of Malaria.en
dc.description.abstractMalaria had been present only in the outskirts and further country, never in the town itself, -due to the unsuitability of the breeding places for the native mosquito but A.gambiae found in the town ideal and preferential breeding pools.en
dc.description.abstractIf the Anopheline mosquito, a much less hardy insect than the medes agypti, could survive crossing, what was to prevent the spread of Yellow Fever to the East by the same means?en
dc.description.abstractAs will be shown, this has, up until now, been prevented by rigid sanitary control both of ships and aeroplanes under international arrangement. What hope have we that this agreement would be continued under the disruptive factors in war? We know from past experience that it would not.en
dc.description.abstractWhat then can be done? The British Empire, at least, can do a great deal which at present it is not doing, and the burden of this Thesis is how and what to do. During the three years in which I helped to control Yellow Fever (1923 -1926) in Brazil my ideal Was to take all Entomological phenomena seen in the laboratory to the field and conversely to attempt to elucidate all field phenomena in the Laboratory.en
dc.description.abstractMany experiments were made and many reports sent to the International Health Board of the Rockefeller Foundation, under whose auspices I was working. Not only was the Entomology of Aedes agypti studied, but also the Epidemiology of the disease in relation to the history and economy of the country.en
dc.description.abstractThe International importance of the question naturally came to be realized, but the opportunity to see for myself meant years of waiting and many thousands of miles of travel.en
dc.description.abstractSince that time - 1926 - I have made 5 complete voyages round the world, touched at all of the large centres of tropical population and many of the smaller, taken the Diploma of the London School of Tropical Ledicine, studied the political and financial situation bearing on the subject, and finally remained long enough in the East (Malaya) to find oút by experiment the relation of my Brazilian findings, as regards the Aedes agypti, to the conditions there.en
dc.description.abstractFrom this, I am of the opinion that there is only one means of controlling Yellow Fever or preventing it gaining a foothold, and that is by the time - honoured and proved method of dealing with the vector in its larval state.en
dc.description.abstractOne admits that great advances have been made in the immunology and serology of the disease and that protection can be given to a proportion of those exposed, but in view of the immense populations which would have to be dealt with in the East, it would be a mere gesture. There would seem to have been a tendency to develop the purely scientific laboratory side of the study of Yellow Fever to the neglect of control and field work, which is an art.en
dc.description.abstractThe great and original demonstrations of this art, in Havana and Panama, followed a very scanty knowledge of the Entomology and Epidemiology of the disease, but were entirely and finally successful, and when Noguchi was making his tragic proto-zoological errors, the disease was being conquered in the very countries where he was making them.en
dc.description.abstractThe main object of all scientific work is to understand, to predict, and lastly to control, but the greatest of these is to CONTROL.en
dc.publisherThe University of Edinburghen
dc.relation.isreferencedbyen
dc.subjectAnnexe Thesis Digitisation Project 2018 Block 18en
dc.titleThe control of yellow fever: its political significance and the special responsibility of the British Empireen
dc.typeThesis or Dissertationen
dc.type.qualificationlevelDoctoralen
dc.type.qualificationnameMD Doctor of Medicineen


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