Jsnuary 1,1929.

ForsddltiOnslnots8 onperiod Jsausry l-26, see psger 122.125 at beginning ofJournal.

1.

Dr. Henrique Aratio mentions the possibility of male mosquito infeotion through

feeding on acmtsminated honey. If this works out it should be possible to presefve

the rirus in mosquitoes without danger to laboratory workers.

January 2. Dr. H.Booha-Lima oalls at offioe to.discuss various matters. I meet

Dr. Aloides Lintc at the DHSP and learn that our oontract for 1929 with the state of

Rio is all ready to be signed and that our oontraot for 1928 was passed as a law of i. 51 ;.

the land by the 1828 legislature. Dr&Lints says therelmsbeen no yellow fever in

the state of MO for more than four months. Although he does not say so in so many

words it is quite olear that he wishes to implioate that his servioe in the state

has been far superior to that of the DpSP in the Federal Distriot. It is indeed A-----‘--.---~.--- _ _-_ diffioult to understand the optimism existing regarding yellow fever in a plaoe

whioh suffered so muoh in the past fran the disease. Dr. Lints for exsmple is un-

doubtedly ignorant of the monthly distribution of deaths fras yellow fever in the

period previous to the work of Oswaldo Cruz. Also he 4088 not properly appreoiate

the importsnoe of today6 ease reported fxan Anohiefa, a suburb of Rio in the Federal

Distriot in direct oontact with numerous populous oenters of population of the

state of Rio.

January 3, Dr. Muench, ,$lr. Ara&o and I go to Bras de Pinna and meet Drs. Ca

Fayate Freitae and Dr. Rodrigues. Dr. Ri&tas shows us a child who undoubtedly

has been having a mild attaak of yellow fever and a woman who is ill but with suoh

vague symptoms that no thought of'yellou fever would be entertained yere it not for

the eases already oonfirmed for the neighborhood. Dr. Freitas says that he believes

that a large number of eases of yellow fear of an undiagnosable type is ooourring

in the native Brasiliirn population.

Dr. Fraga state that the oontraot is almost ready to be signed for the yellow

fever sertiee and that the only modifioations to be made are in regard to postal

and telegraphio franks. The oopy will be ready fasorrow. Dr. Fraga marks our trip

north for the Andes leaving Rio on the 20th of January, in spite of the recent

oases of yellow fever in Rio. Dr. Fraga insists that a signed oontraat be drawn up .- ~~~~‘~.-%/-.~~-L.-----L r-L

between the government and the Foundation as the Minister of the Interior oondiders ~-.-.-/%&.4^-v-u;, 1_ L-.-L I- -L,,, /i-L. ‘-L. ~r.---x/?/~ -- -&.M.-- --~L,'-d, .-+-----L--T_ __ - suoh contraot essential to guarantee payments beyond the term of the present

c--TVVI., -e--- \- -. .__ k________ _~ A--- --7_-.---c_ e/LA

government.

January 4th. 2.

Dr. Ara$o suggests that a large amount of serum be seoured from the Sara Rivas ease in Bahia to determine whether mild oases give the same protection

to monkeys that severe ones do.

ffw I oable Bew York asking for authority to sign oontraot for yf servioe. I get hold of Noel Da&as and Henrique Bias of Bras de Pinna as they are leaving HSS

YO- and take them to OC where HA bleeds them. Msnoel Da&as is a blaok boy from Bahia who had a febrile attaok with oongestion of the eyes two days after being raaainated. Henrique Dias is the unule and rooxnate of the Portuguese who died from yf at HSS removed from Bras de Pinna a oouple of days after Xmas.

Dr. Fraga says oontrect is not ready yet, He enquire8 about the possibility of fellou- ships this year. I explain that we are now on a budget and that the most that osn possibly be arranged will be one fellowship and that even that one depends on the failure of oandidates already under oonsideration to qualify. Dr. Fraga offers his personal help on our aooounts with the Federal Government whioh have fallen into Ereraioios pindos and suggests that I submit a list of these aooounts to him. Our trip to Reoife is still marked for the 20th of this month.

January 6th. Ldiguel Jose Sar#Anna died of yellow fever in Bahia.

January 6th. Sunday.

Dr. Menah and I meet the Andes and get package of Virus of Chioken Sarooma from Burt for the OC in Bello Horitonte and then drive out to HSS.

January 7th. Dr. EiA reports that monkey injeoted with blood of woman in Bras de

Pinna has fever as has also $he first transfer from this monkey. Dr. Raul kagalhaes of Minas is in town. He seems quite optimistio

regarding yellow fever and does not believe

January 8th. I am informled from aonfidential souroes that a womsn from the Rua

Prof. Gabiso died at the Santa Casa with the diagnosis of gastrio uloer but that autopsy showed oharaoferistio lesions of yellow fever. This aase is not being notified to the health department.

January 9th. Dr. Blbreneh and I spend the forenoon mapping Brat de Pinna. Dr.

Almeida de Hello of Par& is now in oharge in Bras, Dr. Rodrigues being ooeupied in Paquetk. Dr. Almeida took Dr. BoydO oourse in malariology and talks w to us about eg upditohes tomesgomyia s.

* --, Monkeys frcK&as-oases are still ru&ing fever. Today for the first time I meet Dr. Braggo, an uncle of Henriqueg,

who is a olinioal inspeotor of suspect oases of yellow fever for the health department.- He says that two Germans had died in Birbaus& house in Anohieta before Birbaumwas

~ diagnosed and that a man had died in the same house with Mrs. Stael, F&o Comprido, a few days before she beoame ill.

Dr. Mauricio de Abreu says that oopy of oontraot was sent to me today. Cable received from RY authorising signature of the oontraot. Tribunal de Contas approves opening a-five thous* oonto oredit to

l33Ti-r pa fifty per oent of expenses in the north and sixthoueand oontos f5r~%hepederal

8 r 0tY . . -3.. . . . --_. The Glob0 oarries a telegram snnounoing yellow fever in Par$.

.B 3 _ .C.._~i --- January 10th.

-

Dr. menoh and I spend forenoon in Braz de Pinna smpping. Dr. Rodrigues gives me his oensus'list to eopy. A girl at 26 Rua Guaporg has fever and is bled for HA,

BoTt\ - HA reports that monkeys from Manoel Dantas and Carmen still have fever.

NY He says that monkey injeoted with mosquito feces shows fever today; monkey bitten

January 10th continued. 3.

By the same mosquito is yet without fever. (If feoal oontamination is the rule the absence of itahing in old residents will explain part of their apparent immunity.

Dr. Fraga oonfirms the news of yellow fever in Par& and adds that a oase has ooourred in Mar&or,. I assure him that Illhxeneh will sail to take charge in Belem on Saturday the 12th. I finally reoeive copy of proposed contra&. CF says that he probably aannot go north tm the 20th as planned.

HSS has suspeot typhoid ease from 3. Prof. Gabito 118. If oonfidential inform- ation of Jan&h is correct this ease msy well be yf.

January 11th. Dr. Paul A. Lewis, of the Rookefeller Institute arrives on the

American Legion. Dr. Lewis is a brother of Dr. Marisn Lew$s of my glass at Rush and Cook County Hospital. Dr. HA, VacafN47ED 69 kftj dt MAW.) @OC. Y

8 sees five oases of yf at HSS,oalls aQ CF and

Januaryl2th. Dr. Muench sails aP Itaquioe for Bel&m; Dr. Lewis aooompanies him

as far as Bahia. I wire Dr. Davis to infeat monkeys of Sunday to have material available for speaial preparation for New York when Lewis arrives.

January 13th. To HSS in PM. Return Dr. Rodrigues his oensus of Bras de Pinna at his

home in Olaria. Existenoe of foous of yellow fever on Ihla Paquetb oonfirmed,

January 14th. Wire received from Roife of suspeot ease there and of illness of Dr.

Crawford. Dr. HA is informed in detail of the teohnique used in lew York for

drying the yellow fever virus.

Secure information regarding oarbon dioxide‘ snow for the Bahia laboratory.

Dra2--$-ys,-pes over-.t-ti proposed yf oontraot and deoides that Foundation interests are adequately p&e&ted. 2___--

_ ~-.-------i/~.~~~. _ -, 4.. I meet Dr. Chagas aaoidentally on the road to OC and am surprided

to have him inquire of me about how niuoh yellow fever exists in Rio. It would appear that part of the oampaign to keep yf out of the papers has oonsisted in keeping oases out of the OC Hospital where information is given freely to the press. Dr.CC ssys that he will see CF and arrange for more oases in OC. CC reports that the Brasilian virus is no longer in the laboratory of OCL

Dr. Costa Lima has been working with HA on the feoes trsnsmission of yellow fever. The first experiment showed that transmission lray ooour either from the bite or from feaal sontamination.

In oonferenoe with CF I notify of suspeot ease in Reoife. CF marks our trip to Peoife for the 10th of February. If CF goes north at that tinm I shall probably remain in Rio and arrange for Dr. Conuor who is expeoted from Burope to meet him.

January 16th. Captain B.A.Warner says that he has been mahle sinoe the beginning

of the present outbreak of yellow fever to get the Wavy to take any preoautions on its own responsibility in regard to stegomyia breeding oantrol. Af+ter disoussing the possibilities, he says he will try to get the Brazilian Navy to instill a laboratory for experimental work on yellow fever.

Wire reports that Crawford is better.

January 16th.

of yf without

Jsnuary 17th.

if neaessary*

yesterday.

To HSS and OC. fever and that

Inform HA that Beeuwkes also found monkeys dying KCD has had the sams experienoe in Bahia.

4.

Wire to Crawford, Reoife, and Burke, Bahia, to increase personnel

Learn that the government opened our oredit for five thousand oontos

and I go to Bras de Pinna and bleed Carmen, Djanira and (leoilia. Dr,CF asks for supply of oonvalescent serum.

roves aotion of governalent in opening oredit _c---.- ---_.---.mm~ ._~~ -__ _ -.

January 2Oth* Dr. Andfade oalls and submits draft of malaria oontraot with the

State of Rio providing that the RF take over the administration of the serrioe snd oontaining oertain other disagreeable features. Considering the faot that

only one year ago the servioe was turned over to the State at their request I refuse to oonsider this proposed draft. It seems very diffioulf for state and other offioials to get the ider that the Foundation is not a business oonoern and to learn that after a proposition has been made that it osn be aooepted or rejeoted.

January 21st. &et Dr. Vilela of Bello Horizonte. He previously worked with Chagas

on Chagas’Disesse and contrasted it himself. His heart is I understand in very bad shape and he finds it neoessary to limit his aotivities olosely,f Dr.‘Vilela says that Dr. Pimentel, dean of the University of kinas Geraes is snxious to get in touoh with the Foundation with regard to the future orgsnisation and developlrent of their projeat.

Impossible to get rooms for &a. Muenoh in Petropolis. I suggest Theresppolis and vaoaine both of whioh are refused.

January 22nd. ).

Carmen (Braz de Pinna) monkey died of generalized tbo. Lt.Col, TT Behrens of the airoraft survey of Rio oalled and was

* advired to have his foreign personnel sleep in the uninfected distriots of Rio. Regis, Lott and Torres fellowships approved.

January 23. , Jr&*&,k*A$

ctrib=

“January 24th. J

* Mrs. Parsons is requested to learn details o Cabral family looking +T~-,Y

toward psyment of funds on aeaount of Miss Iraoem&s death. To HSS and OC.

‘fever in Brat de Pinna; Dr. Penido reports several oases with vomiting and

January ‘26th. Funds transferred for the last payment to the Faoulty of Medioine

project in Go Paulo.

and the photo ~&~resencle of Dr. Maurioio de Abrs

oiated Press. --. .~~_. (

Mrs. Maenoh vaoainated. &y+-yjj%~~e Loaned Dr. Sinval Lins, of HSS, Klots’artiole in Delamar Leotures.

January 26th. Visit HSS and OC,/ Leave bloods with HA for drying. At HSS Line

demonstrates large nuviber of oases to be hot yellow fever’, HA snd I disouss need for further laboratory faoilities in the study of yellow fever in RioL HA says he is going to urge the DBSP to i&tall another laboratory and that the RF might install one here with largely Brazilian personnel.

Monkey infeoted with mosquito feoes only died today of typioal yf. Attend at night in Kiohteroy the presentation of the plans for the

January 26th oontinued. 5.

NEW RBGIONAL HOSPITAL which-is Dr. LiW6' ohief hobby at the present tins. A thoroughly tiring and unoomfortably hot evening was spent by all who attended, Lint6 seys that he has had no oases in the @ate for four.months and eight days!!fl!lf He seem6 partioularly pleased that no further eeises'have ooourred in Nilopolis. He discuss the possibilities of extensive spread later in

r Carnival-I point out to him that e as Chefe of the Prophylaxis Rur

ate of Fragag coul not to oome to t

ot advertimthe true oonditions deral Capital for Carnival. He

0 JORKAL publishes the terms of the yf oontraot.

January 27th. . HB6 report6 the fourth case for Be&, To HSS and find‘sase from Nova Iguas&,f. Thus the bubble bursts

after four months and nine daysL

January 28th. I write to Dr. Burkedthat the inoreasing of Epiphaniob albuminuria

regularly during four day6 looks very sus due to oongestion only. (Kpiphanio is NCD i

ioious of yf and that oough may have been assistant in the laboratory.)

January 29th. The fbnds for the yf servioe in the north were made available under

loredito exlxaordinario. deoreto 18560 of J%nuarr 15th.1929.' ---- - ~--

time are.*mewh& oo1Ifu6~~ On investigai &ZZiautopsies are-beinnqerformed by DrJ Bonifaoio Costa< w-2 is&, but who is preserving tissues from all oases $or final diagnosis by Fialho.

The results of pathologioal examihation6 reported here at the present tioq I find that Dr. Fialho is in Sao Paul0 L-

matholog-

Fialho wa6 previously offered a good positian in Sao Paul0 and &nor ha6 it now that he has gone there to see what oan be arranged. It is believed that CF and he have had a set-to regarding the diagnoses made or disclosed here.

fifteen days. RCD letter to FPR of Jan.l?th repents inoubation period in monkey of

Glob0 in Bel$m in whioh he is quoted as saying that the RF.is u of those whish 0 aammenTwaas

ame methods as OC used in the old da--ith the e&p&n abandoned before now were he still alive, Dr. Tomaz'

lost a mighty good o-keep quiet. HSS has two diagnoses on some oases;that he reoeives a

ial list from,the HosDital eaah da$ whioh is sometimes quite different from DreWred for Dublio oonsumption. CF says that it is neoessary for political o keep the newspapers nd the pxiblio from knowing the true faota in the

1 Lins' fear '--------- --I-- --

l transmitted throughtdiplomatic ohannuls from Berlin, in whioh Kuozinski offers for a oonsideration to oome to Brazil and demonstrate his methods of &!%l%ring the organism of yf. I tell CF what I have heard regarding previous work of Kuc~inski but am foraed to admit that I know nothing of his work with yellow fever.

CF and I disouas the in Riok He says that he gave the OC ei but that he does not aare to depend on their lab found it advantageous for the DNSP to install its own pathological laboratory instead of depending on the laboratory of the OC, he now expeats to do the same with yellow fever but oan do nothing until the present rush is over. Fraga says that our lab should have been here in the first place. h- wrial from our laboratory in Bahia. --T--

January 30th. +--P Mr. Carl Dietsch takes through material for New York. Loaned Dr/ M&to6 "Conf. Afrioaine* for Dr. Sin-1 Line.

*&;z - 6-

To HSS and OCI. Scoured 80 ampules of vaocine for Capt. RAW. -z=.

January 3lst. DR. Juan Barros Barretfo called up and asked for permission to quote

EICD's results with flight range of stegomyia.

Feb. 1. To HSS and find a heavy run of cases.

Feb.2. Advise Mrs. Muenoh of the loaal situation and advise Therezopolis.

Feb. 3rd. ? To Therezopolis for the day. HA happens to be going also and makes

our trip rather pleasant by showing us around. Learn that Mrs. Lensinger is his eieterinlaw.

Correio reports the fir at ease from the city of Sgo Paulo, from the seation oalled Alto de Moooa -

I learn fro%'?isourees that there have been at least 12 s year in Anohieta due to yf8 that most of these, in faot all but

o have been bmer diagnoses to avoid the displeasure of the family at being foroed to permit autopsie autopsies have bwforoemr diwws --.-_ 2 ratkr

Bilopolis is flooded so th&it is ardas to get about fron one house to another. Suruhy is known to be infected.

Feb.Bth. Called Dawson and notified him of the availibility of vaooine. To

HSS. See ALBB of Bahia at DETSP/ c .- _--

Feb. 6th. /‘&Q&L* l.y$ (~kf3ti~uv.L eJ,,n&z ALBB Galled at the offioe and found Uohsa with m'e"r BB interpreti-

olause 8 of the new aontraot to refer to him in Bahia; refuses'to reoognire Burke as "full time medioo". Believes that s and lab material are to be imported at expense of RP acoording to 16 although this olause speoifioally mentions only clauses 10 and 11 and not 18. I aall attention \ to the speoifio inclusion of the Laboratory in se&ion 17. BB says that he receives nothing from the CR but that as representative of Dr. Fraga in Bahia

\

he expeots to oontinue to fisoalics the work of the CR-and that his oooper- i

ation with the CR has always been of the olosest/ To hear him tell it to ; i

me it would appear that he is one of the olosest personal friends of both PEC and AWB. He insists that we need his sooperation and I agree that withy

i

out it we had better pull up stakes and leave. I alsb let him in on the ;

seoret that the CR has no money with which to pay duties on monkeys or any

ion to get all the glory frm yf oontrol in Bahia with none of the worknor bleme for failure and that he is not at all pleased at seeing his position oheihgeing to that of passive onlooker.) I try to tell him that I see noth-

r more monkeys for the work in Rio. CF says that S&o Paul0 ease was a womsn who had been isolated under a mosquito net on the Ilha do Governador but who deoided not to re- main there and took the train for S&co Paul0 where she disld of yf. CF dis- ausses the ocming Congress of Hygiene in Reoife in September and talks about going to the USA in Ogtober of this yeart

Feb. 6th. Speoial shipment of immune monkeys arrives from Davis without any

shipping papers. Wille notifies that German house does not wish to ship animals

beaause of prevailing oold weather. I authorize the expenditure of,funds to oonstruOt weather proUf aages for the animals but insist that they must be ahQ?ped.

C? says that he does not expect to open waocination stations to the general publie but expeots to redem the availably supply of yf vacoine‘ for foreigners, eapeoially immigrants and foreigners living in known fooi of the disease. .

See Rosalvo Martins sent frcan HSS o 39' C.

Feb. 6th. Oontinued.

no new oases.* HSS now has many empty beds and is reoeiving almost

Did the epidemic suddenly stop last Sunday? Jimmie Muenah answer8 to siok call. Drs. Ma&ado and

Warner oalled in.

Feb. 7. HA suggest8 that Davis make early oaptures of mosquitoes whioh

have had blood meal in the house before being turned loose. I ask Davis to send monkey material for the preparhtion of vaooine. HSS received two cases yesterday hoth of whioh died today. Four

oases entered today but all were frora other institutions. (Doe8 this mean that only those oases are being removed to the Hospital which oannot be kept at home?) Report has it that the situation in lilopolie is bad.

Feb. 6. To HSS and DRSP. Complain to Mauriaio that DNSP already has its

CC14 but that we have not yet received our good 8 whioh were to come fran the oustosxs on the same day.

JMello insists that his main diffioulty at the present time is the oontrol of breeding in the roof gutters. He plainly needs more sleep than he has been getting. JM invites me to visit his rone.

Feb .9th. Dr. Maurioio says that our sontraot is not registered and that it

will not be possible to begin paying operating expenses on the odntraot basis before the mnth of Maroh,

HSS has three new oases today. Seoond ease is reported from SPaulo. Conferenoe with CF regarding the ehlorin8tion of the Rio de Janeiro water supply. C? very plainly not interested.

&isg I call on BB at Itajubg Hotel; BB says that the CR is none too strong in Bahia; that who proteoted the CR when everyone else

w that he i?ihe Secretary of lAalth of the State of Bahiai that the present oontraat was made without oonsulting him; that the CR may proceed to assume all the responsibility for yf inoluding fumigation; that he will sit by with folded hands and watoh the performanoe; that by right and by justiee nothing regarding yellow fever nor any other disease should be done in the state without oonsulting him; that

or four thous -- id it for Rio snd the south of od Brazilian he is interested in

the elimination of yf from all Brazil but that as an official of the stat< .of Bahia he is only interested in it8 elimination from that state; that Bahia 18 the ehave to the situation fo%Xll B razil --- and without work in that state that all efforts in other ii art8 of Brazil are useless; that he does not intend to be made BP "IdhWa, by this oontraet;,that hi is the repre- sentative of the Federal Health Department in the State of Bahia and that as suoh he should have a voioe in the spending of yellow fever funds sup- plied by the federal government for work in that state; that he, BB; was quite surprised that I had written to Burke that he should not have oon- suited ALBB about spending money for motorcycle and motor launch, although he admits that he had not felt offended when AWB purohased a new motor ear

BB'says that the CR offended and insult- by sending Hale, a non+nedioal man

&.a;%hat one of Hale's men was orders-of a householder. BB admits

that more than a quarter of a century has passed since the work of ReQd's oommittee and that in spite of the knowledge made common to the world at t that time that neither the Brazilians nor the CR have extinguished yf from Brazil although all other parts of the Amerioas have apparent& been @ lea&d, but insists that it it not neaessary for Bra8ilian8 nor the Brazilian gov-

t0 - f$W &i6fa&oll t0 anyone f or their

suoh failure; that it is entirely own personal affair. BB ridioules the suggestion made by MEC last year

t the state organise mosquito servioes in the interior to be fisoalized by RF employees; if suoh servioes oould be organized by the state they oould also be fiscalized by the state,f BB says that the y2.$.tuation in Brazil is -------

Feb. 9th. oontinued.

tibr admitted; that he is much more diffioult ths.nQzhe RF' has ever known

k&%Wthat MEC had plans all made to withdraw from 'BrAail last y&ii;'that he-has been acau - . . s he'd

barrels as wry ill reoent proposal to readmit

adtiawd. However, he piotures the situation in Bahia as one of sweet oontentment all the way rounds; he loves both Connor and Burke and they both low hitq, BB says he purohases sera and vaocines to the amount of 120 aontos per year in Rio whioh he might well make in Bahia at a oost of thrity to forty oontos but that he has oeded willingly his new seruminstitute building to the CR for their monkey laboratory.

after the abow snd muoh more we- An analysis of the oonference with BB shows a;dozen wiled threats.

ease with Captmwho suspects yellow fewr. rday atnoon. High fewr and high pulse with no con-

gestion and no vomiting. Clearly not yellow fewr.

Feb. 11th.

slight albumen

Feb. 12th.

but report case to CF as suspeat, G has

tihi%3 not yf. has albumin. T-pulse 112. Dr. --

Feb. 13th. G

Peb.lBth. Hake arrangements to pay 20r920$500 against power of attorney of--

General Cabral. Vaocinate Thompsons, Bawsons, Buohanans and Burt. Contract has been registered by the Tribunal de Contas.

Feb,lSth, IL G

S.Uah$a. Ai+ ithmany o urine. s isitfrcm Dr.

I learn today tabella for the P.R. of Bahia inoreasing his ablary to 4:800@NO per month but not inoreasing the salaries of servants and other low salaried helpk His argument was that t_heJrstomed to living with low salaries but that he was not. - H--b Feb. 16th.

Glowr has fewer oasts and more urine today. See three suspeot o oases close to OCI with Dr. H4 and Penido. These look very suspicious but later prove to be malaria.

Dr. CC reoommends a Dr. Fontes for work in Bahia at the instanoe of Dr. Castello Vianna and asks for the lean of four monkeys from Bahia.

( The above mentioned cases sonsisted of a Portuguese man woman ohild who were ill in the ssme house; the child had been quite ill but was improved to such an extent that she was up end about;the man was quite ill and was very oongested with high temperature; the woman was complaining of abdominal pain, vomiting and fevers evidences of black varmit were to be seen on the floor and her interus was wry definite. Dr. Penido made a diagnosis of yf on the woman and I on the man 'if! it were prawn that they did not have malaria!' When the embulanoe arrived they had all fled only to return two days later with olear cut piature of malarial)