4 - _ .9- Jan3.1 Jule being tired and sleepy I came to the office alone in the afternnon and found Jarrett hard at work. Most of afternoon was spent on expense books for November and December. Jen. 3. Dr. end Mrs. M. P. Arrive from S. &ulo Iuneh at home. Jen. 4. MP and 6&a to Nichtheroy for the day. Meet Dr. Otto Olsen of the Secretariat of the League of Nations who is here following up visit of Rajkcman and Madsen last year and is attempt&g to get a coordinated system of reporting on infant mortality in sample districts of various countries. Is eleo going to visit Argentina and Chile on this trip. Dinner and% discus&on with Cept. and Mrs. Babcock. Jan. 5. Dr. Olsen, Mrs. E. Parsons, Dr. end Mrs. M.P. for dinner. 0.0. was vQry much disturbed by Mrs. EP asking if the US were going to cogperete on infant mortality study. HP gives some leaves from history of R.F. in S.P$(ANeiva in 1918 was called from I6~ng$inhos to me&or of SP of S .a. Neive was-ether than ed to essu@xontrol of R.F. work. ned indepenm. %ter when d out of S.P. he requested fellow- ship for general study of &4merican conditions from RF. because 1) This Hackett refused to grant the R.F. did not see value of such 41 study and second) because RF oould not openly give premium trip to party unfriendly:.to new government. Since then Neive has been anti R.F. Salles Gomes was director of Prophylaxis Rural. mt like him and wished to send to US at cost of R.F. to study trachoma but mostly to get him out of country so- could be appointed. JT&&j-J&-J-J MP was to have been this substitute but warned SC of proposed move. Then R.F. refused fellowship and SG bec$% anti-R.F. Iunch at Jockey Club with Nave. Jan. 6. Dr. MP and Manuel Ferreira to unch at office today. HM returns from S e Pa lo. Dinner at Copacabana Hotel. To Casino afterwards with Dr.,and &s. Mario and Dr. and Mrs. Muench. bo d Geor e and family were dining at the hoteMks like his cartoons but is whiter headed than we expected. Jan. 7. Somerncessarg sleeping done in the PM To dinner at Brahma Restaurant with Mp and I@ +Li%.Gw ~6hcr- Jan. 8. MP and MP J.$) and FS go to 12X Mass at Candelaria Church. So named from large number of candles (58) pyramided to a peak and surmounted by the figure of Mary and the Christ child. To ticelsior and Vista Chineaa in the PM. Jan. 9. Dr. Fraga denies of article of Jan 4 in Correio de Mt$ which said that R.F. was not further interested in new work in Braail. Jan. 10. Letter from Ricsrd reports finding stained mosquitoes 5 kilometers from point of I#beration in Led&a. A large number have been found at one and & and 2 kilometers from hatcheries. Iunch with Mario, Tomas and Muench. Dinner at I.25 Bolivar with Ws after long swim sky and sea were gorgeously colored. MP's take train at 10 PM for S Paulo. Jan. 11. Mrs. Parsons, Miss Johns n, Miss Schwarte, @iii Miss Dawson and Mr. Scobie of NCR ve picnic supper at 125 Boliver. E%nani comes to Rio - goes to Bahia tomorrow. Jan. 12. Spend morning at office - Iunch at home. Arrive on board Alcantara but a few minutes before sailing at 3 PM. The Alcantara is a large new'mtor ship of the R.M.S.P. This is the last time this boat is to stop at Bahia snd Recife as from now on it is to compete with other European fast boats and will make the trip Rio-Lisbon direct. The word "Alcantara" must be moorish. In the tea room is a beautiful painting of the @Alcantara Bridge," Toledo, Spain. Among those on board I have met, Dr. Fragd," Barros Barreto, Afranio Peixoto, Wa%de#mar Antunes, Ernani Agricola, Borgzs Viera, Placid0 Barbosa, Pedro Alberque 8, E@ico Rangel, Felicio Torres, Miguel Co T to, Anmury de Medeiros Emygdio Mattes, Henrique Arag%, Theophilo de Almeida, Otto Olsen. Aa beaten at chess by Eugenio Coutinho. Leorne Meneschal directs P. Rural in Alagoas. !+AwF Met Dr. Miguel Cohto for the first time today. A most pleamity. Jan. 13. Am sitting at table with Dr. Ernani, Dr. Waldemar Antunes and Dr. Erico Raagell. This evening Dr. Otto Olsen presented me to Dr. Rocha Lima who has been working for almost 20 years in the Institute of Tropical Diseases of Hamburg. Ieter I met Mrs. Lima and Mrs. H. Aragao. Dr. Lima is most pleasing to meet. fff Both he and Dr. Aragao show great interest in the latest regarding yellow fever in A@.ca llnd Jr the R- q&&yh;Iygyj"?lmhYnJCVyl Jan. 14. Arrival in Bahia. Beet Dr.- de Es arros, Dr. Biao, Dr. Guedes Pereira, Dr. Burke and DhConnor. Dr. Aratijo of Inst. OS. Crux of Bahia, Dr. &@&es--, Barros Barrett0 and others. Dr. Amanry de Medeiros gives the opening oration on Bahia! C. Fraga speaks well of C.R. and especially calls attention to promise of saneamento for Bahia made by the governor. Dr.d#L Barros Barrett0 challenges the ,% ress to look over his work and "take it or leav 2 ,&4 as they wish. The new building for the Saude is very nice. The old entrance is from 1674 - the door and the wooden banisters on the sides of the stairway are ancient and very good. The building is decorated inside and out with old tile. Those in the directors office are especially effective. The central stair case is very cramped in comparison with the rest of the building. The CFA has a room which is furnished by CFA on second floor. Jan. 15. Office Sunday AM. Rocha Lima lecture on Pathology of yf. Peculiar type of distribution of necrosis makes possible definite diagnosis of yf from all other diseases - Necrosis in yf \ is ne@her central nor peripheral but is disseminated in the intermediary zone. Mske calls in PM on ver ous Brazilian doctors. Beet Dr. Costa Pinto end S L a. Leave card for Mrs. Waugh. Dr. Hackett's secretary. To Born Fim fiesta with Dr. P. Alberquerque Dr. Bieo, Dr. Burke and -engineer. Drs. Connor and Burke explain maps and new jars. 1 Jan. 16. Dr. Connor shows me work of guarda in sane 92. Eight houses, 1 steg focus - monthly \ cycle. All porrij'es m&t have spigot and be sealed attop. Kerosene tins end small morin&s are considered fairly safe. Leave sane early for 1 conference with Drs Fraga end Barros Barretto. Dr. Connor outlines the program for the- futu?ceYas fom I mnt program in %rahgbs Natal Recife*and Bahia until July when new survey willb made and further reductions made if conditions warrant. 2. Work will be definite continued in Bahia until Jan 1, 1929 against $", edes #ypti$arvae. CFA will also look -8 after oiling f& cillex on private premises, the 'r DNSP to furnish the oil. control only.) (Our funds for yf Dr. Frege agrees that CFA shall have full autho- rity to inspect all boats and craft in bay for I breeding of stegomyie. I Dr. Gouveia de Berros and later Dr. Fraga visit office of CFA. Talked with Connor over mathematical side of j Yf . What is critical index of stegomyie? Made calls. Evening session of congress devoted to Berros Barreto lecture on acute infectious diseases of childhood in Braail. Jan. 17. 22 houses no steg. foci with Guarde 91. (Burke, Connor, Bieo, Soper) total today 74 houses with 1 steg. breeding.) Visit to Institute Oswald0 Crua. Dr. Aranjo says that he found leptospira in the 2nd rat 1 examined in Bahia and that a large percentage ; of wild rats are infected. He shows a jaundiced ' guinea p&g end cultures of ictero hemorrhagis3L Dinner at house of Governor Goes Calmon. Jan. 18. Inspection in oone wfti Dr. Ro&.Lbw l4 houses 1 focus of stegomyie ie one house with 3 tanks for chickens and ducks breeding. Lima impressed w&i&the small amount of : hanalie carried by the guarda. Afternoon eeseian devoted to --______ -_- ___---- --.. ched, o r. Vienna Junior - Visit Institute geographic0 (Dr. Magalhaes) too late to see more than the setting sun back of the palms end across the bay. Very beautiful sky colorings. Evening visit to top of Nova Cintra to see Bahia by night. Dr. Gouvee de Barros gives paper on work in Recife mentioning especial (jarrae) end malaria. typhoid Jan. 19. To be last day of Congress. Find heavy breeding of stegs end culex on ab%doned ship and of#&.l.ex in abandoned tanks of cotton factory. I hold down the chair while Olsen of the League of Nations discourses on their work in Public Health. Speech of Afrenio Peixoto on the most beautiful story in the world eulogizes Connor among other heroes of Hygiene. Connor not I i present to hear it. Ball et the Palace of Acclamepab afterwards, To bed et 2 AM. Jan 20. Up end et 'em at 5:30 AM. Dr. Emygdio Mattes end Dr. H. Aregao visit yellow fever work at 7 AM. Find steg focus on roof of the Asylum. At 9:30 Dr. C Fraga end Dr. A. Frege visit houses around the square of the Church of Born Fin. A loyal son of Bahia does not return to Bahia i without paying his respects to the Senhor de Born Fim. The church has many wax reproductions of cured portions of the human body end many ; 3 photographs end paintings. One painting of a ' blue eyed boy who was saved from yellow fever in 1892; three photos of a 15 kilo ovarian cyst / operation from which the patient recovered showing different stages of the $aparotomy end giving the names etc., of the doctors who did the operation. 3 PM inal reception of farewells at the palace. Dr. Ama$ $4 , Dr. Torres, D.A. Peixoto end Dr. A. L. Barros Barret#!o made speeches. Dr. Weldemar dines with me et the Fishhouse. Food mediocre, price high. Zeelandia takes Congressistos back to Rio. Jan. 21. Saturday. Downtown in AM end Tennis in PM. Jan. 22. English cemetery - yf cases - churches of Bahia with Dr. Connor - to Rio Vermelho in PM. Cell on WeugHs. r 45 7 Jan. 23. I breeding plant protectors found in 1 house out of 20 houses visited. Farewell to Dr. A. L, Hanros Barretto. The city of Bahia is now divided into 72 districts each district containing approximately the number of houses which one man can visit-in-- - a we&. There are now 18 m on regular service which gives a 4 week cycle of inspection. The ~IHHW works from 7 AM to 1 PM without inter- mission and then is off for the day. Routine house inspections are carried out only 5 days in the week. Fiscelioetion of the work of the nurse is very severe there being 5 guarde chefes assigned to this service. There are also special guardes assigned to the problem of checking up stegomyie foci in vacant houses end to the control of breeding in "places of congregationa ia. hotels, restaurants, pensions, theaters, railwey stations, Lhhools, barracks end churchee. yt is interesting to note that during the -that I had the opportunity of working with the guarde we found no breeding in water tanks in the houses and only once in the clay jar. The foci found were, 1 jerra, 1 roof gutter, 1 open hull of semi-abandoned ship, 3 containers of water for chicks end chickens (all same house) end 7 clay pots for protecting plants from ants (all same house.) This indicates that the tanks are in the majority of cases sealed end that the recent campaign to::provide all jars with spigots end sealed cloth covers has aroused interest in end centered attention on the jars. Spigots are giing in byi.the hundreds and this promises to L hehp control the jerras. Dr. Connor feels that with the number of possible breeding places reduced to their present number that an increased house index will not be dangerous provided always that places of congregation are carefully controlled. Jan 24. Spend AM purchasing tickets on 8- tapuhy for Drs. MEX and FIS and Lunch comes end goes and P igars for Dr. Burke. tepuhy 3s not et docks. Finally sailsWat 7 PM with Dr. Go$veie de Barros Dr. Gu$kies weira (Farehyba) and Dr. Amar@ Machado (Geara) Dr. Abenstha%(Fara) on board. All retire early as sea is not smooth in the ~~tepuhy which has not improved her technique of taking the waves since I last rode her seven or eight years ego. Jan 25. Feel qualmy all day but do not give up the ghost. Dr. Gouveie gets musical and peetical in the evening. The Rio Ipojice south of Recife has three poeos negros, *um dd se&Yes, um dd 46 maleite, um rompe perna que nunce ind$fite." +. asezoesm is from English seasons end refers to seasonal types of malaria. Jan. 26. Arrive in Recife 9 AM. de &gem looks fine from the sea. Otherwise Recife seems but little changed. Meet Dr. Costa and my old friend Ignacio after 7 years. Meet Mr. Freire again of NCB and Mr. Thomas who is now acting manager. Mr. Davis is Am. consul end has just returned from trip to his district et his own expense. Leave at 3 PM in Whippet end arrive at Parehyba via Pauliste et 7:30 PM. Meet Drs. Kerr and Smith. 3f& Jan. 27. Fiscelize 26 houses with Kerr. 1 steg focus found. Work seems to be done rapidly but with very little effort et propaganda. Call on Dr. Guedes Pereira who later returns cell. Suggest that it should not be impossible to'secure the installation of torneiros here. (&. Clark is chief of traffic of G.W. of Bras11 in Parehyba) Leave in Ford for Natal et 1:15 PM. Arrive Natal at 11:35 PM. but have difficulty getting in hotel because .of lateness of hour. Finally get in Hotel Natal. Sleep in hammock again. Jan. 28. Move to Hotel Internacionel. Hotel Natal end Hotel Avenida are both impossible, expecially the Avenide. Cell et Palace end DNSP in AM end leave cards. See Dr. Juvenal bmartine only in the afternoon at 2 PM. It is clear that the governor is interested in the problem of Ceara Mirim not only from the stand- point of malaria but also of economic drainage. The malarious region of Rio Grende no Norte extends along the litoral from a point just north of Ceare Mirim (Touros) to the frontier with Parehyba. No careful studies of Anophelines have been made of this region as far es I could find out here. Regions produois in former.times large qllZlnt~~~~~~-ar~~~~~~~serted because, oTm;;-~eI;fi;r~ **.-r -r.rP-"'. . ,__". I %&-&gey bf these Ceara arim is a striking Cajupiranga is another very malerious zone. I explained to Dr. bmartine very carefully that our previous conference occurred after the budgets for 1928 had already been voted end that the present visit is nothing more than a scouting trip and that nothing may ever come of this *rip. This afternoon we visited Pitimbu, alose to Natal, on a good auto roa with the Governor, his 8 aide end his secretary p. Christobal. Dantes who has been in the USA studying cotton and-&e- speaks American well. Pitimbu had a had reptiation 47 l928 foralerie but according to the foreman is now free from malaria. This he attributes to the opening up of drains in the past two years. Several people questioned but no history of recent attacks could be secured. All children examined did not have spleens except on boy of l.4 who came lest year from Se0 Jose (very malarioas) drains examined showed numerous young Anopheline larvae but no pupae were seen. Many fish in open water. Dr. Adencho de Camara, Chief of Police. Dr. Santiego$Varella, Director Hygiene EstedodDr. Jose Ignacio, under Dr. Waldemar in DNS$ Jan. 29. See note on I & po Jan 31. At about 8:39 AM a special train left Natal on the Federal line for Ceara Mirim carrying the Gov.,myself, Dr. W. de Sa'Antunes,Dr. Santiago Varella and two or three other persons. We arrived at about 10 O'clock end had a sumptuous coffee with cheese, and cakes, etc. After a delay we started out to see the valley of the Ceera Mirim. This valley is very flat and very fertile lying between rows of hills on both sides. The lower course is now abandoned but the chimneys of many abandoned engenhos can be seen in this part. The part now being worked is very productive but is subject to floods because of the blocking of the mouth of the river. The River Ceere Mirim is not easily distinguishable now because of the multiplicity of canals which have been dug. We stopped at a number of engenhos end I examined about 35 children but found no enlarged spleens. Much hookworm is evident. Many fish were present in the deposits of water'examined and no larvae were found. Examinstionsoof water very few. Mosquitoes seen at Ilha Bella were all culex. Lunch et 3 PM in house of old Baron on outskirts of Gears Mirim belonging now to Verelle family. Return to Natal arriving et 6:30 PM. Resume: Ceara Mirim valley is too big for R.F. and is not properly a malaria problem. It appears to me es largely an economical problem. Malaria undoubtedly exists in the town of Ceare Mirim end in certain of the engenhos during the winter months. Jan 30. Examined yf service with Dr. Weldemar beginning in lower part of city in Rua 15 de Novembro. 24 houses visited gave 1 steg vocus I en outside jerra neglected. Surprised to find water piped to many homes with such low pressure that faucets are not used end delivery of water is d&-e& into large earthen jars& in the ground, ip'below the surface. Thus thorough cleansing or even emptying is almost impossible. When 48 we went to the source of this supply we found a large spring with a deep round bricked deposit for storage; at the foot of a hill on which is the home of some German priests. On the hills&de some meters above the spring is a large tank into which water is pumped from the spring by electric motor. It seems that the houses supplied from this upper tank have plenty of pressure but the houses supplied directly by gravity from the lower level have very little pressure and that only during certain hours of the deg. Lunched et home of Dr. Iamartine who has a high well ventilated house built on American plans with slight modifications. Dr. L. has 10 children 5 or 6 of whom were at home. During the conversation Dr. L. ssked what I thought regard- ing the R.F. cooperation in malaria. I repeated what I had previously said about this being only a scouting trip but added frankly that I did *not believe that the R.F. would consider the Ceera Mirim valley drainage es an important malaria problem but rather as an economic one; that if the R.F. came in some time would be devoted to /*ti preliminary studies end that control demon tration$/1:&a I G 8-r w b l/&z that a demonstration and study in the nort o +X !a,~,, At N Brazil would probably be of value for Brazil north of Aleg8es (et least) end along the littoral. ~~&tru.+w4" Dr. L. stated that he would be willing to cooperate L-e"; in every way possible if we cared to come in. L' A description of the conditions found in the Rua 15 de Novembro was followed by a visit of Dr. J.L. to a couple of houses end then to the water supply described above. Dr. L. agreed that this situation must be corrected end suggested that enlarging the tank above end sending all water up to this tank would solve the problem. He thanked me for having celled the matter to his attention. I took occasion to show him that Natal is not now a dangerous point from a pmut that es soon es regular \ $y&+Ih"+J-ay. c by aeroplane with Africa is established Natal es the first Brazilian port d$? call will become the danger point par excellance. Dr. J.L. insists that plans are underway (weigh) to give Natal a reel water service to take the place of the part time service now had from bored wells. In the afternoon with Dr. S. Varelle to the Hospital for Crisncas under construction sincz 1923 promises to be a very nice and useful build= ing when completed. The State Service end Assistencia a?`b together with the usual results. Jentei with Dr. Waldemar and Donna Zulu. Two children Marie Thereza, 8 grs. old end &ria Lucia, .l yr. 3 mos. 49 142$ Jan. 31. Notice from Dr. Iemartine that he had arranged a passage for me on the mail plane leaving here tomorrow morning (Ltocoere) This means that I will be in Recife Wednesday AM about 7 and will be abLe to see some of the yf work there, visit Dr. Gouveia and easily catch the Gelrie on Thurs. at 10 AM. Other wise I should have taken the Itequatie tonight end arrived in Recife lste Wednesday night or maybe not until Thursday AM. hPpo - a very malarious place close to Natal, just across the RR bridge on the line to ~~-pu.&Q 9. Ceera Mirim. The fever here is usually a benign tertian but occasionally es in 1922 the malignant type becomes epidemic. in 1922.) Many fatal cases occurred Cefrlled at the p&lace this afternoon and took up the following points with Dr. Iamartine: 1. No immediate results expected from this trip as far as malaria control is concerned, 2. Future campaign if undertaken must be on health end not qeaonomic basis with radius of action limited to populous centers after preliminary study. 3. Article of Correio de Manha saying RF is withdrawing from Brazil not justified anymore than it was in 1916 when RF entered Brazil. Connor to visit Natal soon end to cal?onDii. Iamartine. (Waterworks) 5. Dr. Waldemafs relation to our work - YF 1 r) 6. Thanks for courtesies extended. f The Gov. offered to turn the state over to me for six months if I return to Natal and I promised to put his fattening secretary (Dantes) on a diet for those months.) Call oflDr. Weldemar end go to his home for coffee. Return to Hotel six PM end receive fere- well cell of Dr. Lamartine, his secretary, adjudante de ordens, the prefect0 Dr. 0. Grady who speaks English and the chief of police. All set to leave hotel et 3 AM tomorrow. Feb. 1. First awoke at 11:30 PM last night to be sure and not miss the 3 AM plane. The flying field is about 20 km from Natal. We arrived there et 4 AM after a wild night ride illr:a Chevrolet truck. At the field we found a biplane and a monoplane, the letter being the machine of our trip. Because of low hanging clouds and resultant darkness we did not take off until 5 AM. Preliminary arrangements included the searching of the flying field with the headlights of the Chevrolet truck for possible stray animals which might be dangerous on the take off. The plane followed the course of the beech from Natal to 50 Recife where it arrived et 6:45 AK Some bumpy I air was encountered the first few minutes in the 1 air but after that the trip was just @in flying. I Dr. Connor met me et the flying field. We first i visited a "jarre " factory where new models are i being made and then on into the staff house for coffee. Then to see guarde at work in down town 1 ; section. Jerraa all practically non-existent now. Visited jarras with attached end sealed .1 ', i fitters. The follow up cells made et homes where i foci had been found were very &ntereating resultihg : in some broken jerres and destroyed barrel&. ' Dr. MT% says the only real serious problem now ' is that of the milltares. The t'feste des Pocasz r ; was later visited which had been vigorously '! controlled by Julius Cesar. No jarras found in i use here now. A visit to the Presbyterian School found Miss Douglas end Miss Kilgore still on duty. Mr. Burt, of Consulate, lunches et steff.house. Dr. Connor end I open joint account et Net. City &+nk. (Mr. Goodman manager). Call on Dr. Goyeie in PM et Dept of Hygiene. See many old friends. We go et Leites with Dr. Souze Pinto end Dr. G. Cerdoso. Feb. 27 Sail on Gelrie for Rio. Finish reading "An American Saga", Carl Jensen. Feb. 3. Bahia. Tennis with Dr. Burke. Beb. 6. Arrive Rio 6 AM Feb. 7. Lunch with Dr. and Mrs. Biel of K.C. at Hotel Gloria. Rev. John R. Scotford, Cong. preacher from Cleveland, with letter from McKinley Warren. Feb. 8. Feb. 9. Lunch with Miss Dawson end Schwerte, Mrs. P. end Mr. I&d&a, iedoo,x Feb. 10. Feb. 11. Rev. John Scotford, Cong. preacher from Cleveland Ohio end mother dine at 125 Bolivar. ROUJf Feb. 12. Grippe all day. Bsrrpn girls and Miss Cobb dine at 125 B&liver. Beb. 13. Dr. A. Untz, Dr. De&o Perreiras, D.A. Andrede end I have session from 5930 PMto 8 PM. Dr. Lintz tries to show us the advantage of tileflfl We are of difficult 51 convictiont For new contract with R.F. I insibt on the organization of a unified malaria service es part of the state department of Hygiene. It seems that Decio .now has the whip hand end it is somewhat doubtful if this measure goes across. However it is the goal toward which we must work. Feb. 14. Prepare proposed contract for State of Rio end submit to Andrade. Feb. 15 Dr. end Mrs. Biel to lunch et 125 Boliver. Feb. 16. Peb. 17. Feb 18 Wnnor wires "R-4 yellow fever Sergipe being investigated.# Feb. 18. Leave Rio on Central at Mrs. I%reons end Miss De$nha#t. Arrive et Campo Bello, hoje Barq# HomePjffde Mel10 at r?Jd? Q.o-mp." d&l, 12:30 PM. We are met by Dr.@Pampos Porto of the Jardim Bote@.co who says that Weltherkis full but that we will be taken care of et the Jardim. After visiting the milk freezing end butter plant we go to the Jdrdim in en old Ford, piloted by one Schuber3 passing the military T.B. sanitarium enroute. At the Jardim we are met by Mrs. Campos Porto, Florita, Estella Rabico (Cepetao Ki-Ki), Dr. Machado, chimico of the agricultural college, and Mario. A purple tree flower called "quaresma fl (Lent) is everywhere in evidence. Feb. 19. Stroll to Iego Azul. Mrs. Parsons reports a hard bed. Children's Carnival et night. Feb. 20. Visit to Dr. Machadds sitio. /--- - ,I /J Feb. 21. Leave Jardim (816 Mts.) at.1 PM horseback and arrive at Maceiras (4960 mts.-)'& 4:3O PM. My mule)Prenatel Influence, is entirely impervious to all forms of physical stimuli with the exception of blows rained upon the heed between the ears. A delightful cabin with apple end peer trees forms the uppermost station of the Jerdim. All the comforts of home except spring beds. Feb. 22. Leave Maceiras et 6:3O AM end arrive et foot of Agulhas Negras at 9 AM. Reach top of peak (2951 mts) et lo:35 AM and get batik to base et 11:30 with clothing soaked with perspiration. 2 PM. Return to Maceiras arriving about Iunch, dinner, bridge and bed. 52 Feb. 23. Leave Maceires at 7 AM and arrive et Jardim et 10 AM after side trip to Welthers. See Doneti. Take 1:40 PM train for Rio. All reach Rio with new appreciation of spring beds. Feb. 24. Holiday. ("Day of the Constitution") Afternoon at office. Letter received regarding transfer of Kerr to Paraguay. Feb. 25. Set. ) Heavy reins. Feb. 26. Sunday ) Feb. 27. Annual report seaked by rain. Mrs. Parsons insists that she has no responsibi- lity in helping collect funds from the government exen the' the responsible man is assigned to her service by Dr. Fraga; that Alfred0 always has collected these accounts and that our bookkeeping staff is no more full of perfection than is her service. Consultation w He has m ofslspect Lan our notices of Sergipe Asks about fillow- I ship end sbout possible help for School of Hygiene in Rio. Promises to send proposed list of candi- dates and proposed project before Congress to me soon for transmissel to N.Y. Feb. 28. Pedro Dias was informed by phone that the Bank of Bras11 in S. Paul0 had refused to receive the money for the State Treasury from the National City Blank destined to pay the first installment of the Medical School. w ,4 7 To &g&r&es with Alfred&D to see about old accounts of 1918-1919. Good promises received. Feb. 29. Annual report. Mar. 1. Mrs. Parsons and Mame LeDoux to dinner. Mar. 2. 3. Saturday - Still running fever. 4. Sunday. Afternoon et office. Kvening to see Merjon in Gentelhomme de Paris. 5. Dr. Fox, Quarantine officer of Port of N.Y. calls in Rio. 6. t= 7, Dr. Fox and Mrs Dr. Werner and Mrs. Parsons and Schoenfeld to dinn r. 2 53 March 8. Dr. M.P. arrives and dines at 125 Bolivar. Mario says that all county health units except those in which the R.F. is interested have been taken from his direction and are now in charge of Dr. Salles Comes, long autagonistic to the work of the Foundation. Mario should soon be out of this mess as he has brought up his papers all in order for a felloWhip and FJR has written promising approval. FJR believes we should arrange no new work with Sao Paula as long as part time basis is used. March 9. To the Prev@torium for TB boys on &pueto (Dr. Madeira is chief of service) run by TB League with help of 120 contos from Federal Government per yey. In charge of Spanish order of Sisters. To I$ha das Flores to see immi- gration stationfi PM. Capacity for 4000 under pressure. 9 and typhus taken to Ilha Grande. Other s ckness handled here. In time of epidemics all immigration through port of Rio; now mostly through Santos. 10 cases of Trachoma waiting deportation. Dinner with Mario at Brahms. Mar. 10. Saturday. (7 cyl /' z.5 Mar. 11. Dinner with Dr. and Mrs. Peter Warner. (Capt'n. Navy) and Dr. and h-8. Charles FoW home of WarnerIs. Supper at Hotel Palace with Fox's. Mar. 12. Connor and Burke have gone to Aracaju. Burke writes under date of March 4th "They? \ were trying to slip the word to Rio,that Sergipe had yellow fever without letting se# criado know anything about it, so I just rested my foot on ! the floor board until I was satisfied they were not in front of me, which however, resulted in neglecting other observations.'p/ Connor reports 95s of houses in Recife without jarras of the old type. Conference with Dr. Fraga and Dr. IaFayette' Fraga is also informed that not available this year. March 13. Dr. Waldimiro advised that Foundation help not available in 1928 for Food Chemist. March l& Iunch with Schoenfeld at Jockey Club. Annual Report finally sent on today's boat. March 15. Idle day at office. March.16. Sail at t, PM from Rio on @@Avelona" of Blue Star Line. Meet Dr. PedFo .Xisto, rooming with Rev. Smith in Santos, and S$fr. Guillermo de Escurra of In Nation B. Aires. The conversational 54 I efforts of the three of us, one Brazilian one Argentine and one Ameridan-lasted until 2:30 AM in spite of the arrival of the Avelona Santos at 6 AH the following morning. I was particularly interested in Rscurra's discussion of the Argentine political situation and did all I could to keep the discussion on Argentine politics and away from Braoilian politics and literature. Irogoyen&Hippolyto) was really the secretary or assistant of the organiser of the party which finally broke up the old aristocratic policy of passing the Presidency around fro one great family to another. At the time Aa ' he took over the machinery of the party and had himself elected president. For years he ruled all Argentina even the provinces without appearing at public meetings. He has been described as the President that nobody saw. He worked entirely through agents who came to him for orders and they went out and fulfilled those orders and reported to him on conditions in their section of the country. this respect he was very much like Borges Mede d@ who ruled Rio Grande so long.) When he came to the Presi- dency, he surrounded himself with unknown mini- sters of little talent. He believed in direct rule of the president endninisters were to him but high class secretaries. Congress was allowed to meet, his message was sent to it by a servant and it was not consulted in matters of government "To the victors belong the spiirdlsa was the order of the day and all public employees were changed. Internally then the government was bad but externally seems to have been good. Strongly nationalistic, Irogoyen refused to enter the war with Germany or permit the cooperation of the R.F. in health matters in the Republic. When his term drew to a close he elected Dr. Alvear, the present President, to succeed him. Dr. Alvear had the following qualifications: He had spent three &dl&herited. pa rge fortunes which he 2. He had lived a great many years away from Argentina and hence had no political alliances. 3. He had always shown himself tractable. In office however, he failed to agree with Irogoyen on the qusstion of federal intervention in.the provincial elections of the province of Buenos Aires. Since this divergence of opinion, the party has been split i&&the personalistas for Irogoyen and the antipersonalistas those opposed to his domination of the Party. The Minister of Public Instruction under Irogoyen was a primary school teacher from the interior. He was burlesqued in a play which ran for three 55 years in BA of unknown authorship (at the time. Later discovered that it, was written by an em- ployee of the Ministerlo.) The minister is first shown receig ng the telegram in his tiny rural school in Jp bJ notifying him of his appointment. When he arrives in BA he asks the servents of the ministry how to behave on various occasions. When asked by Congress for an explanation of his educational programme he says that he believes in "Sound minds in sound bodies" and in shoes for ever 3 scholar. (Not so bad for hookworm at that. March 17. St. Patrick's Day in AM. See the gash in the side of Mont Serrat and learn from the paper that on the 7th of March the prefect0 was notified of the crevasse on the side of the hill; the pre@$%o notified his engineering service to report but nothing had been done-when the catastrophe occurred. Result 107 people killed by 300,000 cubic meters of earth. 900,000 bu. met. are still expected to fall. Leave Santos at 8:25 AM arriving in SP at 10:19. M.P. not at office because of operation on one of his boys but comes to hotel at 2 PM. We go over the local situation which remains largely unchanged and then call on Borges V a. v Barges reports that the work on the In&i ute should soon begin as the final contract is to be signed Monday. Borges promises me a letter giving the actual workn>w being done by the Institute. M.P. reports that some doctor, enemy of Paula Sousa's, but whose identity MP does not know is reported to have said that the only salvation of the S.P. of S.P. would be Geraldo's recall from Europe. The work of destruction goes on apace. M.P.*s proposed trip to the US has been given as the reason for the transfer of all non- Rockefeller posts to Dr. Salles Games. The Rockefeller servile has not yet been touched; the state service hmwever has gone back to the Delegacia de Sande plan with Pascale and others of our old service acting as delegados. Afranio Amaral has returned from the US and gave to the newspapers an interview in which he states that the Institute of Butantan does not yet exist - in fact never did exist but that now it is to come into being under hisrnble auspices. Jayme Pereira, who has recently become professor of physiological chemistry, by concurso and is therefore untouchable rose to the occasion in the medical society and insisted that this inter- view must have been erroneously reported by the papers and that he expected a public denial on the part of Afranio. SO- Dr. Rebello, of the Police, stood with Jayme on this and the firends of Amaral raid nothinu- ~_. . + 56 Mario believes nothing can be gained by going to Julio Prestes now and explaining the position of the R.F. on full time employees for public health work. More rope must be given although it seems that the higher powers are beginning to realiae what is happening. Two months more should bring matters to a head. Accidentally meet Dr. AT Pinto on the street. He has "good news for me " but what I want is money and not any more good news. He promises money for the end of April as he now has a government job which is to pay 1:450$ per month. I tell him he must pay as otherwise I must protest his notes. WL pzd &., Hotel and early to bed. March 18. Sunday. Dr. Pedro Dias calls at 8:30 AM and we visit the local of the new medical school where we find Dr. Sousa Campos waiting. The excavations for the foundations are finished, much lumber for forms, cement, rock and gravel and iron are already on the ground. A short branch line of the trolley line has been made and the power lines are just about ready. I explain to P&&-o Dias the money available and the manner of payment and it is agreed that we will send 600 cnntos per month beginning with April which will mean 6,000,000$000 paid by the end of 1928 leaving 409:000$000 to bepeid in 1929. It would semm that the work will go forward rapidly from now on. Dr. Sousa Campos insists that everything is being weighed and measured on arrival at the ground; and that they found a shortage of 600 kilos on iron delivered. On our return to the Hotel, Dr. P.D. and I have a long talk over the local situation. He says that: he always was antagonistic to P. Souaa but that he realises that his organization of the SP was good; that he recommended Moreno and others as director and not W. Oliveira; that W.O. had been P.S.(s right hand man and fully in his confidence but that as soon as P.S. is out he became his enemy; that he is trying to destroy all the work of P.S, When I ask why PZD3 takes pencil and draws picture of a burro with a rider. He refuses at this point to name the rider but later admits that it is Arthur Neiva and Salles Gomes. Pedro Diesels only connection with the SP has been through the section for the verifica a^o dos obitos. f Since P.S. left this service s becmme continually worse. Few cadavers are now received and generally these are four or five days old and putrid. P.D. understands that the service is to be discontinued. I ask why? and am told that Paul0 Sousa inaugurated this service and that the enemies of P$S. are 57 now riding. (I suspect that the unknown doctor mentioned by Mario Pernambuco yesterday is none other than Pedro Dias.) P. Dias insists that he it was who secured the approval of the budget for the* School of Hygiene with the promise of 800 cantos from the State; that B.V. in the absence of Paula Sousa is with- out great influence. Julio Prestes asked P.D. if he were not in favor of the School of Hygiene as part of medical school; he replied that he had had that idea for the-betterment of the school!!! but that the arrangement between the Gov't and R.F. provided for certain things and that he had promised Paula Sousa before he left and had promised me in fromt of the Secretary of the Interior to make no move toward such inclusion of the school in the Faculdade; that in the face of the previous understanding the government shoulddther approve this budget and get on with the work or should return the money already spent. The result was approval. I discuss with P.D. the R.F. attitude on full time. He cites the case of Dr. Nicolas Moreno who had a good practice and abandoned it entirely to devote himself to food examination and is now reduced from 3 to 2 cantos per month and from full to part time. P.D. a.9 bluntly who will explain to Julio Prestes our attitude on full time. I tell him that my relations are through the Director de SP to whom I explai ed & this attitude some months before the chan was made. I further state that I believe it will be difficult to secure R.F. cooperation beyond 1928 in face of present facts of all part time liemployees. That such discontinuance of our service is disagreeable becaursse of our long association of 10 years here and that we are sorry to see the situation as it is in a state where we have spent much over 1000:000$000 in public health work. (I suspect this interview will go in a few days or less to J.P.) Dr. P.D. says that he is responsible for the appointment of Afranio Amaral and that although A.A. knows this he has not even co@e to call since his return. Furthermore the inter- view on the I&W existence of Rutantan has reflected on P.D.'s choice of a director. (Yes the world is still round.) P.D. says that all Amaral ever knew about snakes etc., he learned from Vital Brasil. March 19. Conference with Dr. Waldemiro de Oliveira mostly devoted to accounts with *P.D. insists that there had been active blocking of the Institute plans by Neiva et Cia. Neiva is starting a new Biological Institute. 58 R.F. and to Nuse's Training. When I mention possibility of talking health work to Julio Prestes, W.O. changes the subject immedietely. To Santos by car and Rio by Andalucia. Arrive at office at 11 AM March 20. P-p Mar* 20. Reports from Bahia indicate that 2 Arapjo called tissues from Sergipe positive for yellow fever. Tissues have 81~0 been sent to Rocha Lima in Rio and to N.Y. Reports from 1 Connor at Estancia say no new c8ses have appeared.! Conference with Dr. Fraga who feels cases may be y.f. I discuss freely with Fr8g8 the details of the S.P. situation in Sao Peulo and suggest that a visit of his in the near future might be of value in preventing the passage of the new project by Congress. Meet Dr. A Carins v in Fraga*s office. He recently returned from's hospital inspection trip to the USA. . March 21. Rio. March 22. Rio. Andrade brings in counter proposal of State of Rio. Not satisfactory. &rch 23. Connor reports Sergipe c8ses probably \ "C.-/l,, t-, 'L ix- not yellow fever. March 24. Very hot. To Petropolis in PM March 25. Petropolis. Heavy rain. March 26. Return to Rio. Kerr arrives on . ..- Eeelandia. Telephone call from Rocha tima says c8se of Estancia (Maria de Lourdes) *positive I for N.f. March 27. Advise Drs. Fraga and bFayette that case was diagnosed 1 .f. by Dr. Rode Lime. Wire Connor and also wri e Dr. Russell. Muench 8nd i; Kerr leave at 7:30 PM for Belle Horioonte. I March 31. Sat. &Hospital prOp8g8nd8 meeting at bldg. of the Empxegados do Commercio on the Avenida. Very hot. Mrs. Parsons introduces Miss Dorothy Morse whohss been 5 years in Chile with the ME Mission as nurse. Mrs. Parsons cnnsiders available for work in Arthur Bernardes Hospital on return from the EUA. Dr. A. Lint8 from state of Rio suggests con- ferenoe tomorrow. April 1. Meet Dr. Lint2 at Cru8 Ver 4- #ha at 11AM. Dr. Renato Machado shows us his installation for e8r nose and throat work. Dr. Castro Ar8$jo is also present. Discussion of contract forces 59 to the conclusion that old contract must be renewed. April 2. Dr. Frsga says Rio is now without anti- steg service 8nd hence vulnerable to y.f. if imported from Sergipe only 3 days away. (Wire Gonnor of Frega's fear.) April 3. April 4. Visit Estrella, halfway between Rio and Petropolis with Drs. Linta and Dr. Godoy of D.C. Inst. where new study '&biology of mosquito and also of malaria is to be made. The land and buildties are to be furnished by a real estate company and the State of Rio is to furnish some funds for installations. The work is to be done under direction of XC. Chagas who goes to Europerext Saturday. Kerr returns from Minas. April 5. Thursday $ holiday. April 6. Sexta Feira Santa. Dr. Kerr and I take the 5:30 AM Berca for Nichteroy and the 6:3O train for Capivary, only to find that Drs. Alcides Lint8 and Decio Perreiras had arrived at 4:30 AM examined one or two ditche by flash- light beiiig much annoyed thatDr. Andr de& $ had not received them and had then proceeded to Rio Bonito on the 6:lO train. The high water from the river is b8cking up on the lowlands about Capivary and we find the tiles doing heavy duty in 8 reverse direction. zzthatbikmen do not kbow- paris gr=n should be spplied. good lunch is enjoyed in spite of Holy Friday. T&r3 -helps the return trip 4 w A- to 8n expected pleasantness. Kerr and I arrive 2% -f