35. Dr. SUchGa and wife luch at 125 Bolivar and later in the afternoon mjuca, Vista Chineza etc. SU expects to sail for the north abouththe 15th of the month. sEig% ALBB from Bahia calls at the office; his first greeting is rather ut the situation suddenly turns chilly when I refuse to order scales 19or his service to be imported duty free. I explain just what our understand- ing is with the government but he is not interested in explanations, only in not paying the duties. We discuss practically nothing and BB leaves coldly and even repels the suggestion that I should see him at the boat at the time of his departure. To OCI and learn that culture &veeb3r_K.-&o&C(,was app_arently dead and was probably a recently transplhiid<6lture as the tube gave no ev!i.- &$%e of prliferation within the culture medium. July 30. Mag& bleed 44. Jul 31. Jayme ?zciiik Pereira and family sail for New York. JP believs that with any possible change in government that Paula Souza will return to the Health Deparlment. And of course the government must change in September a= Julio Prestes is a candidate for the National Presidency and must leave his present office six months before the election which occurs inMarch. ALBB e een on boat-vem c l(Qr@_disz& even to the point of veiled insult. eet Mrs. Ridgeway end two children n Boat. Ridgeway is now in BA. CF states that a new credit of 'S,OOO:OOO$ has been opened for yf. August 1. Mag&bleed 42. w* HA repor$s that K presented second_.apparent..y dead-culture to CC. f course the answer to th&is that CC is not GaGable of keeping alive the ,.t culture of K. K has reported that his work is being confirmed in England. d Decio Parreiras has submitted to CF a budget for the state of Rio in the amount of 6:000:000$000 for yf control. It is understood that this budget begins to operate in the present month of August. Informed CF thatMEC is withdrawing services frcnn the interior of the state of Bahia. Pramise monkeys to Penido for trachoma work. CF states that Minis~~,r__ofI_ntsri~~~~.~.~-~~ -~-~.~laints frpn.Per_nambuco tha%.-the `service In the interior of that state is not adequate; CF requests that I wireMEC sugg;esting that the service in Pernembuco be intnsiaied. WSAntunes lunches at 12 Av. Ruy %rbosa. Nothing new in YF. Au st 3. Wires ?i$%tE, received from bothMEC and NCD regarding possible gallbladder also regarding visit of Rocha Lima to the laboratory in Bahia. All day in office. Miss Owens from Kansas appears, KU 1901. LaFayette de P Freits calls about Antonio Ignacio who later appears in person with his wife. I go over the situation with him in detail and try to make it clear that under the present regime there is little potsibility of our being able to arrange any subsidy for his services in Recife. I make it clear that we expect these services to continue as in the past but that we do not feel that we should :>ay for them. He assures me that there will be no change in our future relations tind that he will continue to do everythirg possible to aid and assist in ctirrvin; out the yf programme in 1'ernembuoo. Wires mentioned above were one fromEBC askinga about suitable surgems for Davis gallbladder in September and one frcan Davis saying MEC telegram had been sent without his knowledge;bothMEC and NCD insist that news should not be for- warded to FFR. ROChh Lima wire made enquiry as to intentions of RL regarding monkey inoculations. 36. Y= Andrade and Ferreira Pinto shamefacedly admit but thirteen bloods for ast Saturday and attribute their hard luck to their inability to hit the veins. Following wire received late in the afternnon from NY "Following received quote returning Europe offer exchange full installation antimaryl cultural work Kucsunski unquote not answered no vacancies in our organization request reprints you deal with him." Ferreira Pinto takes Pereira B&to to OCI and bleeds him; he and I bleedMAr. McArthur, Senador Vergueiro 68. Pyles refers to theMomsen child as having an attack of something which may have been yellow fever and sug.yests bleeding. Wire received from New York stating that K has ofi'ere.d-tc.go ~to NY to explain everything there. I em authorized to treat%ith him but with the -injunct- ion that tlnere are no vacancies with the Foundation. Visit dentist and am advised to have tooth out. august 6. TOM&-forty one people bled. v Taking Dr. Tamas with me, ygo to Msnguinhos to interview Kucsinski. K e-- akes pains to explain that he sent the wire direct to NY only on%ie?T%itie-%f t9o frieas ;!11,1 ':52i`3 -<3;*~ much interested in his work. The only friend he ment- ions however is Dr. Selwyn-Clarke, who, he says, spent a couple of weeks with him in Berlin and had an opportunity to appreciate at first hand his work end his re- sults. His two friends, including Clarke, had insisted that he take the matter direct to headquarters by cabling New York. (K evidently thought that I would be irritated at his attempt to go around me; however, Ibelieve he is no longer able to irritate me about snything as I know more or less what to expect from him.) It seems that the Foundation has more money to spend on yellow fever research than anyone else and he thinks that his great discovery should be presented to the RF under such circumstances that would admit of rapid confirmation by an able group of investigators. At the OCI he has been unable to secure sny cooperation until quite recently with the return of Dr. Chagas. When pressed to state his price, K refuses to do so but believes that living expenses in NY are probably higher than in Berlin; he should have sufficient for himself and his technician to live ccmt- fortably there during the time required for his demonstration. H says that he wishes to vindicate himself to the RF because he knows that the RF is skeptical regarding his work and he hax received a letter frcan a prominent soientist (name not stated but probably Rocha Lima) who says that neither the Pasteur Institute nor the Rockefailer Foundation have any faith ti his works. I almost replied th& faith without works is dead but refrained. The upshot of our conversation was that I told K I would transmit the details of our conversation to NY and would inform him if and when I received any further instructions frcm NY/ Following the discussion with K, Dr. Tomaz and I call on CC and place the whole situation before him. IQ says that the culture is now in the hands of CCruz and that within a very few days we will kno;v '.he worst. It is believed that the first cultures given were dead but cultures are now growing in various media. CC expects that a few more days will tell the tale and promises that he will take pains to let the scientific world know Qust what the results of g's demonstration at OCI were; CC says that K has been placed absolutely in his hands by Guinle. (QF course Guinle has not yet received the news from Africa that K is here at the request of and paid by the Rockefeller Foundation.) Oswino Penna calls at the office and inquires regarding the remarks of B HA on his publication of Councilman's report. My only reply is that HA had suggested that Rocha Lima had been misinterpreted and was given credit for saying things that had never been said. . May report to CF/ L earn that DNSP has been paying on monkeys to the Cia. Docas de Bahia each month in spite of our labors to the contrary in January. August 8. Ma&&3'7 persons bled. August (9). Take bloods toI&nguinhos. y1 HA reports that RL would like to make the trip to Bahia as part of the trip to Recife for the Congress of H ygiene. CF given copies of our correspondence +th the Minister of Viaqgo regarding monkey importations. 37. August 10. Ferreira Pinto toMage alone-collects nine bloods. Andrade and Maneco Ferreira both come to the office highly ex- cited over the most recent desaforo of the secrett. of the de~,a~t,me$&,..of.- _-.. _I - Hygiene in Wichteroy, Yesterda~~-p~~s~d~~~~~e that the servents of the department were not to attend any of-the wants of-the CjR;today a notice went up stipulating t%&-AA wan%%%& G-'be-z&ided in the personnel of the C&! AA had discu:;sed the first portaria with Lintz but has not yet discussed the second one. I authorize AA to invite Dr. Lintz to call on me again. Call on Range1 to see system of filing cases of yf in Eardex; and on Amadeu Fialho to secure names of cases from which tissues were forwarded to WY. To Circus party at Country Club. August 11. Quiet day at home with the old folks. 2%-%l Lintz has said that there is no reason to call on me until he has en up t e matter with the secretary or the president of the state. I find it hard to believe that eny director of a service can be so molhe in regard to his subordinate personnel! JU reports that he was recently able to infect monkey with fourth day mosquito. KA furnishes copy of RL letter to K written in German on J uly 19. (This to counteract the remarks made to me about some scientist who had written to K about the Rockereller Foundation.) Hear Valery-Radot, grandson of Pasteur lecture on Widal and his work. August 13. ' Raul Magalhaes calls at the office and agrees that the need of__t__he~ RF for stimulation in the county health programme of the stat of Nfinas is past& / .__.I-~ .--.---; ----. -- ._.. . ..~.._ _. . . .;`. %%ever~~h?'i%-very desirous of securing-th con%inued dooperation of the RF in the state even though it should be on a reduced scale. I indidahe the possible entry into other Qpes of service, such as statistics. A& reports that he and Ferreira Pinto called on the secretary of the i state yesterday and that Lintz and Decio did EO immediately`thereafter. To- .; &y another round of sessions is to be instituted to attempt to clear up the ' situation. RaulMagalhaes reports that a suspect case of yellow fever occurred recently in Juiz de Fora. Onset day following arrival frcm Rio de Janeiro where patient lived in Rua Francisco Eugenio. AUKS; 14th. Ferreira Pinto reports a total of thirty bloods fram& yester- his makes a grand total of si.5~ hundr,e-d tl?regty.~-~-E-F;~~-..~ledcher~,. AA reports that the .sec%tary of the department cUqes agains- to the Sect- brought official -- of the State. He does not say what these c=ges w";rliSi%ut I gatgahat they had to do with remarks that had been made by U and reported to the secretary. AA to go to Michteroy again today. Lunched with the Federal Deputy f.rcnnMacah~ and insists that he can bring heavy political pressure to bear if necessqy;y. EP+reports that lcM'$s very easily influenced by others. Now under influence of SE: both believe that they are the only ones with either ideals or ability. SE to go on leave Aug. 23 but does not care to discuss plans for vacation at this time. Conference with CF. Says that there have occurred in the past two days two suspects the first of which proved to be gastroenteritis on autopsy ad the other of which recovered. The latter case came from the Rua General Polydoro 162. Discuss various phases of yf with Waldemar, Lafayette end ljhza. AA reports that another(the third) portaria at8aoking the RF has appeardd in Wichteroy. The Secretary of State has decided that the entire quest- ion of this misunderstanding should be sett&id by Lintz and Soper in conference. w$%k%G%%o be a serious illness. WCD writes under date of Au&gust 9th that AVVB is ill second day of 38. Wire frcsn Met confirms BBRKE as yellow fever withmonkey inoc- probably infected in laboratory on AuTust 4th, onset Aug. 7th, returned to work August 12th. $*~$$$&i$fl$~";&; ';;>$JJ ag& alone _ "he late in evening and arranges to call to JTA and I visit HHS where we find a suspect case of yf from the R. Dcxningos Fern&ties, Madureira. Does not look like yf. Noite reports a case removed from the R. General Caldwell. August; 18th. Sunday. Worked in AM at home. AA calls and gives details of Nlchteroy situation. August 19th. Drs. Lintz and Becio z all at office and invite me to call on the secretary of the State of RIO wi.t@b: hem in the afternoon to discuss the sit- uation in the state caused by &-and VM. I accept and spend the hours from four to eight making the trip. Decio does not show up but Lintz and I go to the Secretary's office and discuss the situation. After thorough discussion of the situation in which it appears that U should have taken the matter to Lintz in an officio instead of taking it to him direct. It has also been charged :-hat the first officio y,y::; -t.::1,ycd-: I;;- f:--s-.:; nrlil t.h,rt therein AA had acted against the proper procedure in such cases. The solution offered of the prqssnt case is that .the Secretary has already ordered the author of the offending document to take it down from the wall and is disregarding entirely his petition for punish- ment of AA; .furthermore, AA will be given an office apart with separate telephone and separate servant. (The suggestion is made that the removal of Martins should be accompanied by the removal of Andradel! !) I accept the solution offered as the Secretary gives all kinds of assurances that he is with us body and soul but that he feels that there is a certain amount of error on both sides. August 20th. AA advised of yestedday's conference and told that he may re- turn to Nishteroy where he is to have a separate office and a separate telephone and servane. Later in the evening he calls me on the phone and reports that his new office is the room previously used as a deposit because it is right next to the latrine and hence not desireable because of penetrating odors. He further- more states that the notice written by VM is still on the wall contrary to the orders of the Secretary and that Lintz is not giving him a servant but is offer- ing to pay the magnificent sum of one hundred ei$hty milreis per month toward hiring a servant. &FP Receive wire from FFR stating that another honintelligible cable een received him again. in New York from Kuczinski and suge;esEi~~~~t-r~~~~~~~~h Prepare officio for thexretary-of State of Rio and also one for Dr. Lintz calling attention to the failure to remove the offending document from the wall in Rio and saying that we will be unable to use our office there as long as the author of the note is &nployed in the departient. A copy of the note to Lintz as well as a copy of the offending document are sent to the secretary in charge of Dr. Ferreira Pint& on August 22nd. Give specimen of convalescent serum to Dr. Fox, Professor of Skin at Columbia (?) to take to Davis in Bahia. Offending paper still on wall in Nichteroy. Document sent to Sec. as stated in yesterday's diary; to Lintz by registered letter. (f>:/;*, Prof. D. Matthews of Forestry at ANN ARBOR and,cg@ @rester.cgand family $vJ<,,/zi. I arrive. Rrof. Matthews to dinner with Dawson's and Halls. Dr. his article on y Oswino-Pe5.a calls and is very curious to know the reception of fever oatholog in New York. ---------sn<-;-$iing impreSSiOnS on the League of Nations situation and on the Braalian situation. PS says that the most level headed man in Eurze today ia GK_s/ arou:ld t~a~~ozfjernambuco got mray ;v';i; PS says that the rumour is going some eight hundred cantos of the RF. Conference with IQ and Waldemar de Roofsa in regard to the payment of the SP accounts. ?@ asks for and receives a letter dated August 1st giving the debit with us of the county of Candid6 Motta; MP im&ikts that there is an account of Sert&ozinho of 5:055$100 which has been entered twice in the accounts. Also c*-211s attention toThe fact that Piricioaba has paid its debt of something over eight Con-Los which was paid by WR the last time he was in Rio. Dr. Pedro Dias lunches with me. NMhing particularly new 1caIlled on the lr.cal politic:%?. :i ';:::?;'Uf (,I. . Call on both Neiva and Rocha Lima. RL to go to Bahia on the Southern Prince the first few days of Ogtober and then proceed to Recife. Djne at home of Dr. Paula Souza. r. Spend three hours yoinp; over the new Faculty of Medicine $$'%$%ro :?za'md Dr. Souza de CempGs. Lunch with Dr. WO who has as guest Dr. Figueira de Mello, from someplace in the North of Brazil and who now has the same place in the department that WO previously occupied. Sleep in the afternoon. August 26th . Spend forenoon with Dr. Paula Souza at the Institute seeing how they are bui7.t. Lunch with Dr. RochaRima at the Hotel Aurora. Dr. Rocha Lima is beginning to take lessons in English. After lunch return to the Hotel and await the coming of Waldomiro marked for five oclock. Iv0 does not come. Dine with Pedro Dias and Souza Campos at the home: of Pedro Dias: a great long jantar of some seven or eight heavy courses followed by an evening of music with DoEa Julieta St the piano. Very little of value learned aside from the fact that Julio Prestes made Pedro Dias a present of the new ford which he is driving. I admit the possibility of this gift but also call attention to the fact that Pedro Dias only began to drive this oar after the cons-tru ction of the new medical school Was well under way; to this sally Pedro Dias responds that the most serious thin: is that Souza COCOS is building or has built a new house. Souza Cam;jo:; insists that he was careful to make ah purchases gor his house from dealers who were not furnishing material for theschool to which I reply that his very care on this point put:; him under .;us:pici.c,r,. Return to the hotel at ldic!nie;ht after an evening of Chppin, Liszt, Bach, and Aloysio de Castro! August 27th. Spend the morning at the lotel. Dr. an? Krs. Pcrna.,,,bxc 1. :,s>& .;;:th - I-!,0 . YP s:;-: ';hat Pedro Dias is justifkdd in his complaints on the lees of clientele after going to the medical school. MP explains it as due to the free talking of the medical students regarding the kind of instruction that he is able to give them. including one WO asks for three Pellowships*for himself. He says that he expects to leave the Directorship of the Sanitary Se&ice when Julio Prestes gets out; that he did not request the appointment in the state of S&o Paula and that he will not request any appointment for Rio de Janeiro; that he does not know whether he will be taken to Rio or not and if taken does not know in what cap- acity he may go. In the meantime he has become very much interested in the sub- 40. ject of nutrition and would like me to secure for him from Dr. Russell the promise of a fellowship to study nutrition. I explain to him very carefully that there :re no funds available for fellowships this year but that we expect to have funds available for 1930. However, I stress my doubts of the possibility of securing from the RF in New York fellowships for the state of S&o Paul0 for anyone who is not a full time employee of the Health De- partment; WO comes back to this point later and stresses the fact that he is a Delegado de Saude and hence effectivo;he does not discuss the point of full time. In regard to his fellowship I am forced to point out that not even Dr. Russell has authority to grant him a fellowship at the present time to take effect after he has left his present position; that before all else the Foundation requires the recommendation of the Director of the Service and as no one knows at the present time who his future chief will be, no steps can be taken at the present time to guarantee anything. Dine at an Italian restaurant with Borges Vieira, Lucas Assumption and two otheryoung doctors, all of whom with Rocha Lima and Waldemar de Rocha are at the train to despedir me. Take train at nine oclock and refuse to pay ten milreis for a bottle of Caxambu. August 28. Arrive in Rio nine AM. Among others find the following letter which at least indicates that opinions differ. Caixa Postal, 387. Bahia August 21 1929. Dear Dr. Connor: We received today about forty thousand of the enclosed folders, a recommendation by Dr. Clementino Fraga, advising the use of fish in mosquito control. I presume the purpose is to ha ve the guardas distribute these sheets from house to house. Personally, I do not see what good will be accomplished by their distribution. There is no objection whatever here to the use of fish. The public accept them as a matter of course, following years of custom. Dr. Sebastigo'Barroso's bolshevistic explosion has apparently been forgotten. The only question is how much we wis`r 'c spend in the distribtition of fish. We are convinced, I believe, after a very fair trial, that the public will not aid us in this enterprise. Do we then, want to distribixbe fish to tinhas, talhas, and similar deposits, as recommended by Dr. Fraga, and, if not, why the propaganda? I think we are already spending more money on fish than the results warrant. We know from experience that we areobliged to fish large, permanent, otherwise unprotectable deposits such astsnques, and caixas; but if we are going to extend this service to include tinhas , *alhas, barris, porroes, and the like, it will cost considerable money, and in no way aid the campaign. I shal await your instructions in the matter. Very sincerely yours, AWRurke. The Situation in the State of Rio remains unchanged. AA is working in the Rio office. August 29. I submit personally the June report for the Yellow Fever Service to Dr. Fraga. Visit to Davis for preliminary discussion of rental of house. August 30. - -'cfp-l /jC$ Inspect for the first time the foci map of Rio. According to this map the c8ntr8 of the oitv is clean whereas the outlying distriots show many fok. WSA reports that today he found very much, however, were oulex.) Conferenoe CF. he has been unable to find foci in the oentre of town but forty foci in outlying districts. (This may not mean as it is entirely possible that the majority of these foci CF EUJ~O~~C~S ppose of oonsecrating his ad$iis_tration.. e"-."- .rlr .__ -... -- __... ^ -. --------_-- .___ _._, _-. _ to the prfiem of yellow fever. I called his attention to the *act that we have "reoe~$.5%%% oases-recently in'venezuela and that Colombia is probably inf&t& altZ%ugh i+r$ii&S GnfEm&tion~has not possible. t seem to realfse-the-possible si.ificanoe of -u-H.-- -----_ .- ._ --.. -_ -.-. -- .--- - unexplained reappearanoe in these other ooan-tri.es, CF~~%-e%?%pe%&s-%o-star?~ to ParA about September 15 and will visit as much of the north as possible before attending the Hygiene Congress in Recife. CF suggests that the Foundation m-present the accounts of last year which are in exerciuius find-. August 31. Wire MEC of possible trip of CF to Pa&. September 1. : swday. Cox family to dinner. .&' September 2. CF assures me he oannot leave Rio before September 21. Again suggests r8-presentation of 1928 aocount with a letter stating that the Foundation is desisting from the oollection of that account. em%-- * that there is a suspect Ee o~Yr_at-,.._~.~~_Ti~-s. our secret service or$anizaGL. That speziks pr&$v&ll for Visit the hospital with Dr. Tomaz Alves a;7id,L&~ and find that the ease, the first in seven weeks, is already dead. There is no history of the patient having been away from the oentral part of the . 5: oity for some days end he resided at the Hotel Sublime very close to the Hotel Central. Diagnosis oonfirmed by autopsy. (For politioal purposes this first ease &ter the interval should have oocurred in Nictheroy or some other point of the state of Rio. ) Authorise AA to request audienoe with president of the State of Rio. Jensen de Mellows to dinner. September 4. Hotel ellow Fever oase died yesterday at HSS. Italiin from Sublime -. . v"'y q September 5. Conferenoe with D8OiO regarding situation in State of Rio. D8OiO proposes integration Of Malaria S8rvio8 as solution Of present difficulties. September 6. To OCI with Cox and Matthews. Penido shows experimental traohoma in both human and monkey subjects. are both direct transfers from a human case. --&?%<&A 27 &- September 7. Holiday. Office all day. September 8. Sunday. September 9. I&,t,er No. 494 written to Dr. F. F. Russell (see pp. 4la-kla for letter and answer. COPY 9th Septex+xx, 19;9 Dear Dr. Russell: Your letter of AuSus-t 10th regarding the st;Aies in Leag6 mm8 as somewhat of a surnrise to xc. l%e idea of attackl3.g the enidemiology cf yollotv fever from the stand too 'nt of immwzity _ distribution i2 a i;-- iven pooulation has appefaled to 35 siwe rather early in the Rio egidexic. 'L3xsl ye 3. ? ow fever occurred in Bras de Pina, a suburb of Rio de LTaneiro, i:z Dece-:;ber of last year, Dr. TFuench and I plamed on an epidemiolo 25 c~z.1 study of tho place. :';e spent sor.ie tixe i.3 making a map a& Sattiering cert2i.n pr'elimi7ary infor3wtio.n. Ho-Kevor, before this work Ilad gone very far, it 5~ came neoessary for Dr. hluench to go to Par&. and other interests preverr-Lxx? :zy going on wit)-; i,h.e study. Only f u.r aera ?:rc:re sen", i-.? frcm Bra>: de Pina but the reslllt s :7ere very ixtcrestFnS. You :iill find them co:xwnted 01' in :qy letter ?:o. 133C: of r,!ag S4$h. Brw dc Pim is a small suburb of X.0 where zuch difficulty in gettin blood specimens xas anticipated. ns u *j!,R yellow fever ixfcction spcead to various places in the interior, it appeared thy5 +. r;lore zlear-eut s-kuxly could be :nade in cozxw-&ties where the date of the introduction of the disease ;:,i$-;iC be rather definitely established and wk:ere rn?eated invasions had ~0% occurred. Prom this stsxdpr)ilZS;, I had considered the possibility of wor'+q in Coryntho, fdinas Gcraes or in Xag6 in the state of :?io. con- trary to the inference drawn i-i your letter, Xage -m.s not chosen beoause of any interest ix Kagb as such. Mag6 was chose:3 becnv.se accurate lllaps and other ix?orrkxtion were avail a?sle f'ron the time of Dr. Boydfs Xalaria Service there. A2tother fe.ctor c.f prkne iqortance in causing the selection of hiag6 was that tke doctor l-rho had already direoted the Mal-aria Service was available to assist in the study You can readily apprecis-te some of the difficulties connected with git&ting a 1arS.e n'tnpber of scra from tl-ie general ;-:opul::';ion.; Dr. Fer:'ei.ra Pinto~s nersonal frimde~~bps I have proven i?vsluab!e in this resl7eo.k. "ltiter cnreftil consid?erakion 09 the .:>ossi>flitiss l-m-e I wis!? to sugcst the _tollowing for j'ow COXL sideration:- 1 That yre z!&e ar: zt+:erqt to study c~roflllly G.m an epide-4.oloSic2.1 standpoint one infected zone in the Federal District and one infected tam of tiie interior. 2. T3.z.t; 8s pu-t of this ::tudg we t&e blood specirrsni; (20 to 25 c.c.) fron as large a nwnber of i,y,divi4ual.s as possible. Thn-t YE ir!.s-tall ". &__.,. :: mall laborl:xto;-y wl1tx.e senrn can be separrltec! from the above specimens and 2reparcd for exa?fnntion at any time in the future wherever monlcq s and personnel 8re avaiL able." what I really wished to suggest was "that as part of 'this study we take blood specimens from as large a number of individuals from the general population as possible". Your letter opens the whole question of the epidemiology of yellow fetier in Brazil.to disoussion. At the present time, there is no generally accepted criterion for determining whether, in a given omunity,oontrol measures should be undertaken or not. For example, Estanoia and Mag6 are oases in point. As you will remember, the first ease of yellow fever diagnosed in Brazil in 1928 occurred at Estancia in the State of Sergipe. The autopsy and epidemiologioal investigations were made-by our servioe; although the autopsy was later proven positive, from epidemiologioal studies of oonditions in Estanoia before and after this ease, Dr. Connor-did not believe the ease to have been yellow fever. Dr. Connor was unable to fi& any l&al history of yellow fever during a period of a* least fifteen years and therefore assumed that the nollimmune element pf the population must be suffioiently large to guarantee further diagnosable cases were this ease truly yellow fever. . Dr. Fraga, who saw a ease of yellow fever some years ago in Bahia whioh had originated in Estanoia, 00% sidered Estanoia a dangerous foous and insisted that oontrol measures be instituted. Dr. Connor refused to institute control measures be- lieving that the ease was not yellow fever. Absolutely no oontror measures were taken in Estanoia and, as &ar as is known, no further . oases have occurred. However, &d an immediate diagnosis been av- ailable, oontrol measures would probably have been take? the the ab- senoe of future cases attributed to saoh oontrol measures. In Mag6, on the other hand, rumours of yellow fever have been trgjoed baok as early as Deoember, 1928. The first kn~m posi&ive oases ocsurred about the midd&e of February, 1929. Ho:Jever, no oontrol measures were taken until March 21st, The apparent resul%s of oontrol measures were almost immediate; Dr. ?Del Wegro, who iras in charge of these control measures, in the first to suggest that the oessation of the epidemio was probably not due to the measures of oontrol. As you will see from the accompanying map, the twenty one oases admitted as:suspest by the Ho&h Authorities are widely scattered in the heavily populated part of the tcnvn. The anti-mosquito service in Uag6 has been mintained during the winter season ;:nd will undoubtedly be aontinued more or less indefinitely, whereas other towns of the same size which have not produoed oases of yelluw fever are without such service. If anti-mosquito services must be maintained indef- initely in all small towns where yell&w fever ooours, the elimination of yellow fever will probably prove impossible because of Zack of funds. (Dr. Connor has adopted for North Brazil the policy of inaugurating control mrasures in the smaller interior points only when yellow fever is proven to exist and of abandoning suoh measures when the apparent danger is over.) Is iC not possible that townrr where yellow fever has not yet appeared represent greater ,potential dangers than does Gag6 where there may be a large immune population? From a theoretical standpoint, the peroentage of immunity in a given population may be almost as important a factor in ltiitirg the spread of yellow fever as is the mosquito index. In faot, the entire program of control of yellow fever in a district by controlling mosquitoes only in the larger centres of population is based on this prinoiple. The importance of the mild undiagnosablo oase of yellow fever has been appropriately emphasised only since the demonstration that Xacacus rhesus can be infected with the yellow fever virus. It is true that some of the ed&er clinical des&riptions of the disease called attention to such 'cases but these were in general disregarded in actual epidemiologioal investigations. It would be of the greatest value to know what percentage of oases of yellow fever are mild snd not oapable of olinioal diagnosis in different age, raoe and nationality groups. Dr. Wilson has recently reported a small epidemic from the interior of Pernembuco in whicn e&@ cas; OF--&e ow*d in a population of o&undr&md seven neople. Records are also v of ship infections where a large percentage of the orews were attacked with a high mortality. In the ease of sh&p crexs, we are dealing with a foreign population and in Dr. Wilson's eijL demio we are dealing with an interior town where the population is probably of Indian blood end may be, for $&poses of yellow fever studies, entirely distinet from the population living in the ooastal regions of Brazj.1, Similar high inoidenoe has not been observed in native population here during the reoent outbreak. Many of the details of the present epidemic in South Brazil are explainable only on the assumption that the virus of yellow fever may behave somewhat as does the virus of polivelitis in which disease only a small percentage of individuals show character- istic lesions of the infection. I believe it has been demonstrated in the laboratory that the virus of yellw fever may-undergo definite ohanges of virulenoe. May the same thing not occur in natureg`: It has bt:en interesting during the present winter season in Rio to note that a number of warm days following a cool spell produce a few suspect wases of which none osn be definitely diagnosed as yellow fever but that with the return of cooler weather, not even suspect oases arc reported. Most of our knowledge of yellow fever in Endemic areas has come from observations made on cases occurfing in adQlts more or less recently arrived from non-endemic areas; previous to the dis- covery that M. rhesus may be infected there was no satisfactory method of studying yellow fever epidemiologically since only fatal ci.4+&4h+AL.~ cases oould be When yellow feveFreappeared Rio de Janeiro in parent / L"r+yy absence of twenty years, the looal authorities antiaipated a high inoidenoe of the disease among natives of the city in the younger age groups; however, suoh was not the oases the disease being apparently limited largely to reoently arrived foreigners and to Brazilians who had come to Rio flrom other parts of the oountry. Some would interpret this urr- expected distribution to indiaate that yellow f&or has never been absent from the Capital and that the looal population in largely inrmune from having had the disease; various other explanations have been offered, all more or less unsatisfactory. (In this connection it is interesting to note that the older authors state that yellow fever was largely limited to foreigners when it first appeared in Rio de Janeiro in 1849.) Jimmxnity studies in various groups should a&d in solving this problem. I regret that this letter has grown to suoh proportions and is so indefinite; in conolusion I would bay that I believe that the yellow fever problem in Brazil oould be better defined had we available reliable data from various parts of the country on the distfibution of immunity to the disease; I fully realise that general studies of such distribution are extremely expensive as long as monkeys are required for the tests but believe that the informglCion gained from limfted studies of a few well selected commun ities should be worth while. With the previous methods of study of the distrib ution of yellavr fever, little more than the gedgraphical distribution of the disease could be ascertained and even that was frequently at fault. An -unity sur'frey such as we hope to get from Magb should enable us to visualise what actually happens when yellow fever is introduced into a small community where it has not been known to exist for twenty years or more. Although we have bled a large group at Mage, I had never considered using more than one hundred monkeys for this study; Dr. Beeuwkes suggested that worthwhile results might be secnned with as few as sixty animals if the cases to be studied were carefully chosen. We are now engaged in an analysis of the groups from which we have blibod specimens and hope to have thoroughly representative material to ohoose from; the only immediate result of this study will be the determination of the present distribution of immunity in MagB. I shall probably forward this material to the Bahia laboratory in the near future but no tests will be run until we hear from you. I would appreciate a cabled reply. Very sincerely yours Dr. F.F. Russell, The Rockefeller Foundation, 61, J--WY, NEW YORK CITY (Signed) Fred L. Soper. The Rookefeller Foundation, International Health Division, 61, Brcadway, NEn YORK October 23, 19;9 Dear Dr. Soper: The amount of work which I have had to do in making our 'book of estimates for 1930 and the necessary arrangements for our annual meeting has prevented my replying to your lel+ ter No. 1494, dated September 9, 1929. This letter 5s a most interesting one. I think the study which you have planned is one that sooner or later we should make and the way you have outlined and advocated it is admirable. It may be a minor objection, but it occurred to me, as you will have noted from my cable of September 28, that since this is yellow fever work it should be done in close cooperation with Dr. Connor. The second point is the expense involved, which is very considerable, and our yellow fever expenses are alre,Ad;!- high. Mr. Frobishtr has, as you know, been making studies on oomplement fixation in yellow fever and when he left he told me that the test was just as reliable as the Wasserman test. His experienae in New York was of course limited. In Brazil he oan pursue his studies further on complement fixation and in a short time, if the test works out 8s we hope it will, it will be possible to make the st&dy which you hatpe outlined not only in Magd, but in other toMns in the north and south of Brazil. I can see the value, as you point out in your letter,of such studies in mqy plaoes. Beoause the problem of the neoessary laboratory work of such studies is such a big one my own inclination would be to postpone the program until such time as Frobisher is ready to run complement fixations on sn indefinite number of human bloods. As you see, I look upon the study in Mag6 which you propose as merely the beginning of a series of similar studies. If in the meantime you have any othen ideas of such studies I hope that you will talk them over with Connor and will write to me. I am anxious to have the studies made as soon as they oan be done at a reasonable cost in money and in $ersonnel. I am sorry that so much time has elapsed since the reoeipt of your letter, but you oan well understand that press of work has prevented me from replying earlier. Very sinoerely yours, (Signed) F.F. Russell. Dr, Fred.L. Sopr Caixa Postals 49 Rio de Janeiro, Brazil 42. g+$+-. ERR arrives from BA on the Sierra Morena;repobts a good trip and e did not cone on the American Legion which ran on the rocks in Monte- video one hour before they passed her. The situation in BA appears hopeless to ERR for the following reasons% There is a widespread antipathy to Americans in Argentina and the present government is unwilling for any foreign organizations to administer public services in the country; the present administration is using government services for patronage only and is making no restrictions as to the Preparation of individuals for government employment. More specifioally, our contract has been definitely broken by the government through the deliberate refusal to give free entry for belongings of Dr. Rickard; There is no further field for the type of work that the RF was doing in Argentina; the studies which had been planned for the ooming year either have already been made by the govi, or are of a type that would not justify the expense. ERR feels so keenly the futility of going on under present conditions that he must resign from that field if the RF decides to continue. ERR states that he returned to SA for the pur- pose of seeMg the Argentine Service through but that now that he is convinced that there is no future for this service, he is willing the return to the USA and leave the Foundation or he is willing to work until the en& of his present tour of duty and retire on his return to the USA. He requests that I discuss his decision with FFR when I arrive in NY/. News arrives that there is another hospitalized case of yf. ERR and I find a typical fourth or fifth day case from the R. Assemblea-no history of outside oontacts other than a passeio to Santa Thereza Hill three or four days before onset. Visit OCI and converse at length with Arag5o. Sept.11 Wire New York regarding Argentine situation. Dinner and Bridge at the Dawson's. Sept. 12. Visit Service Haritimo to request data.on immigrants. Lacerda promises to get the desired information and shows UB through his sefvioe; says his gener- al index in March when he took over was from 27 to 35 $/; index now is low, His service is repponsible for twenty four iShindS and all the oraft??the bay and employs %epOge@ight men. ERR and I visit one of the Islands with L in thefast Crissoraft with Chrysler engine. Sept. 12. Reoeive letter from the Secretary of State of the Stite of Rio in whioh exception is taken to my interfering in his department!! I I !I Later in the day JTA and I go with Decio and Lintz to interview the secretury regarding the placing of the Malaria service in the Health Department. A definite proposal is made to the Secretary and it is believed that everything will be peaceably settled. MO close out service there. ERR embarks on Asturias for BA having been authorized by telegram Finally secure tissues from Albina Xavier from DNSP laboratory.' Case from Assemblezdied yesterday and has been confirmed. Case in Nichteray died this morning. Sept. 14. Range11 promises cards for Monday. Sept. 15. Sunday. WSA oalls at house and gives information regarding origin of ease ajing on September 12 in the Rua Assesnbl8a. This ease was undoubtedly infeoted in Niatheroy. WSA reports absolutely no breeding in zone where ease ooourred \1 -6 ~~&d&Q~' Sept. 16. MEC arrims on "Zeelandia". Sept. 16th. Continued. MEC in very good physical condition apparently except for a orop of what he aalls tropioal boils. Believed to be the dame thing from whioh Crawford has been suffering the past six months. Local swellings appear deep in the tissues without fever and gradually oome to the surface. Are accomp- anied by a newrotic prooess but tend to heal readily after incision and removal of the neorotic oore which readily slmghs out. Call on CF with MEC. MEC tells CF that he is more optimistic regardinK the yellow fever situation in the North than at any time in the past. In reply to enquiry CF states that it will be impossible for him to make his proposed trip to the north beoause of the recent appearance of cases in Rip. However, he very definitely intends to make the trip to the Congress in Recife in October. MEC enquires as to the 3s odi o o _D and suggests via Par&'and but on the other hand glibly discusses my return suggests tha Id like 5" vacation about May; Talks vaguely about possibility of taking indefinite vacation a~t?'%-i%"~%ays he has not suggested to FFR that he would like vacation. Call on Servulo and Waldemar Antunes and meet others ofthe yf service. MEC dines at 125 Bolivar. MEC says that FFR is thoroughly convinced of the Wisdom of having staid out of Rio this year when the oppotiunity was given as long as we could not come to the DF at the same time; I do not discuss the matter at all. b!EC decides that ERR is best placed in the Rio office especially as he does not oare to remain in the field beyond the present term of servioe. MEC asks then that power of attorney be made out to ERR but that all authorities be notified that MEC is the dire&or ad interim during my absence!! It MEC and I call on Evi$ and get en offhand valuation of six wontos on the car. Sept. 17. Call on Lacerda end arrange for MEC to see Maritime Sanitary Service. Visit Bsanguinhos. Sept. 18th. Mrs. EP birthday. Madame Mesquita, Schoenfeld and MEC to dinner. EEC spends morning with Laoerda seeing the I!daritime Mosquito Service. Budgets forwarded to New York. Se t. 19. Day at officte. Janses de Mello calls and gives account of his yf ser- *other details. Dinner with Van Hoo~@B. MEC spends AM tisiti,Wg ships and lighters with Lacerda. Call with #%%agao and meet Penido , Ozorio and Costa Lima. Call at DNSP and make arrangements for MEC to see service on the land. MEC does not wish to oall on CF but I insist which turns out luckily as CF already knows all the details of MEC's visits to the Earitime Service/ CF takes the bull by the horns and invites MEC to visit all the zones in Rio and makes entirely different arrangements for suoh visits than thos that have already been made. Sept.21. Invitiation received to send delegate to the Congress at Recife with expenses paid by the State. Reply that FLS, i&C, MB, LS, PJC, DBW and NCD would attend but that RF would pay all expenses. Lunch with Rave at Jockey Club. SUNDAY/ PACKING/ CHURCH WITH THE TRUSTEE. MEC begins land study with Moscoso in Copacabana. suspect claimed to be malaria by pays furniture 3t999$000. Se t. 25.AA reports four suspect oases in Merity. d-m Co in s invites MEC to visit yf service, says 0858 at Mefity was pneumonia, promises acceptance of our sohedule and early incorporation of personnel. Dinner with Commander Wilson. &&%a'-% about 3 PM. Se t. 26. AWB telegram regarding trip to BA by plane arrived at 11 AM; plane MEC and I visit OCI/ CC says that Costa Crue reported his work on K's germ last night. Find Albert0 da Cunha in CC's laboratory. CC promises to send copy of report on K's bug. K was quite able to hand le the sit- uation, took his medicine smiling and csme back with more than Costa Crue knew how to reply to. Present EEC to Dr. Games de Faria. Take coffe with Costa Lima and Miguel Ozorio who report on &.arther details of Costa Cruz report. 44. Se t. 27th. Visit Mauricio de Abreu to arrange further visits of b%EC to the ???????????? o Board ????*??? to see AWB who is returnigg to Bahia.MEC says he be- to plan of setting Burke go home on vacation soon transferring Wilson to Bahia. AB permits two of his men from up country to lunch at the nurses dining room. Call on CF and discuss the importation charges on monkeys in Bahia. Explain that we believe the matter is fully settled by the recent telegram of the director da receita to the Inspector in Bahia. CF asks me to take the matter up directly with the Inspector in Bahia without attempting to work through BB. CF says that BB received direct call down from him end also through the governor Four cases reported from Rota de Brejo on the line between )$@$#' &@)@~:;vello and Diamantina. MEC attends a cocktail party at the Dawson(s. SUNDAY 29. PACKING all DAY.!!!!!!!! Sept. 30. Mrs. EP and Miss Morse dine together but apart from our table; MEC invites Dr. Tomas to dine at his table. Advise Mrs. Andrews to limit activity in office to things connected with the service. Arrange for Miss Calasans to leave the service. Lintt reports decree signed for the Malaria serBice. Dinner at Jack- son's. OCTOBER 1. Govt opens further credit of 8t000~000$000 for yf. Sail on Zeedlandia for Bahia with Rocha Lima and his technician, Miss Seiler. act, 2. that Ho- is an ex-army medico who came to Cuba mng the Euro&n war and has b een busy making a local reputation for him- self publishi_np:umerous articles on yellow fever and other thinAs of which he knows-as littler RL insists that Hoffmann has n0v-e~ a caue ofyf. First- made a big noise about the pammound in the kidne -%r?l%%ii& from yf -special streXnZX6e -?- .cII- esion- li&T*F~4a reproduced_h_is liver plate _- without g@i.ng due- credit on the pla% its=RL considers thexple stXt%&%inthe te6that the plate is by RL insufficient. October 3. On Board. `botober 4 Arrive in Bahia early in the mornings Davis, Burke, Shannon and Kerr come aboaid. Go to Pensao Edith; F& and teohniaian to Pensao Harbord. Spend most of the day at the laboratory at tiontserrat. The laboratory is very well installed in a building originally built for the manufacture of sera for the health department. The grounds are spaaious and after many difficulties have been planted to vegetables to help feed the animals. Beside the main building there is a garage for two aara, an outside animal house et present devoted to guinea pigs and an incinerator. On the ground or basement floor of the main build&g is loaeted the unused animal room3 here also are to be found the main stoak roam, the aarpenter shop, the gas machine, and a well sareened room for guinea pig experimentation. On the main fioor of the laboratory building are three main divisions, the general room, the mosquito room and the infected monkey room. The general rocsn is protected by a doubly screesktd entry and the only entrance to the mosquito room is through a doubly screened entry from this general room) in the center of the mosquito room is e large screened cage in which the aages contein- ing infected mosquitoes are kept; this large oage is divided into three aom- pertments, the first of which is the doubly screened entrance, the second is work room where feeding experiments are aarried out which is separated from the third and larger aampartment by a screen door; this third compartment is the storeroom for the cages containing infected mosquitoes. There is no entrance from either the general room nor from the mosquito rocun to the infected monkey room. RL visited the laboratory in the afternoon and indicated what mater- ial he would like to have for tomorrow. October 5. Saturday. RL and technician appear and start to work. Kerr is work- -ing on liver and kidney functional tests; if fever in Au would seem most logical to *hiti that he had hrmw of fresh infective blood. To carry through these tests K has been taking blood from certain animals each day after infection and has therefore undoubtedly been handling a ae$tein number of bloods at their most infective stages in the cent- ri@ging of suah bloods and the separation of the sera day after dey it is possible that he came in direct contact with the virus although his work 45. has been done with rubber gloves. Immunity tests with bloods of NCD AWB and JAK are to be begun tomorrow. Oat.6. Sunday. ALL dsy at the laboratory, then to Davis hame where I find m, Irwin, Stanley and Franklin quite grown up. Mrs. Shannon is entertaining the children when we arrive. Burke, Kerr and Shannon oome in later for dinner. Oat. 7th. Vacant lot inspeotions with AWK. The yf servioe now has a number of squads of four or five men each aleaning vatsnt lots and hillsides to prevent breeding. The loa81 regulation of the lixo serviee does not permit of the remov- al of tin oans at the expense of the prefeitura. Therefore the yf service finds it necessary to bury them after they have been thrown over the wall into the most oonvenient vaoant lot or hillside by the servsnts. The problem of hillsides and vacant lots is muah more difficrult in Bahia than any piaaoe I have ever been; it is rea)ly quite surprising the .aotual area of the oity devoted to steep hillsides. s a total force of some two steg +n my room at the Pensao Edith. October 8th. Lab all day. October 9th. Spend morning with ANB going over details of local service and %rying to learn how a service is organited. Burk does not believe that the steg index of Bahia was ever very muoh below what it is at the present time. For some weeks now B has been oheoking the index of the GC*s visit with the guarda against the index of the guarda's visit plus the index of the SC's visit behind the guarda. In the beginning these two indices w&re widely div- ergent but lately have besoma more or less the same. AYD oan give no speaial point in whioh the servioe of Bahia is so diffioultt both the ind)or and out ) door servioes are difficult because of the the hillsides, the laok of water X supply, the failure to remove tinoans and the utter inability-to secure from BB any cooperation in enforcing regulations. NCD and I aall on Inspeotor of the Alfandega who suggests that we get an order from the Minister of the Fasenda to him to ooncede freedom from duties on all impottations of monkeys into Bahia. ioate that he has hads Mosquito aatohing enda of Dr. BBarretto. Dinner with Davis and Family. October 12th. Offioially a holiday. Spend day at Laboratory. Davis purchases oolleotion of monkeys off the boat arriving from the north. October 13th. Sunday. Morning on the beach. Afternoon at the Laboratory. Ootober 14th. Dr. Rooha Lima visits Control Servioe in the forenoon. Rest of day at the Laboratory. Ootober 15th. Dr. and Mrs. Frobisher arrive on "Almanzoran. Burke and I join Dr. Connor for Recife. Drs. Davis, October 16th. General disoussion by our group of results of vision tests on guardas in Bahia, also szme disoussion of olassifioation of houses and of the impertanoe of extraneous breeding. the members of the Camgress of Hygiene. Official dinner of Captain to Drs. Davis and Burke do not attend. Disoussion with Dr. "ontenelle regarding the Sohool of Nurses. F insists that the nursing profession oannot make rapid progess in Brazil as long as all nurses in training are required to live at the Nurses* Home. Fhas been chosen para ing the history by this year's class and desires information regar& States that h-not been on speak- ..-.------ . - . .*_(. I_ .,,._ - .-.I 46. October 17th. Arrive in IPecire. Meet Drs. Doyle, Cardoso and Crawford, all of our Service. Official reoeption at the Palaoe in the afternoon. Official opening of the Congress with addresses by Drs. Fraga, Amaral, Gouveia de Barros and Professor Fialho. Dr. Fraga pays tribute to Dr. Lewis and thanks the Foundation for its oooperation in Yellow Fever Control on behalf of the Government. Ootober 18th. Visit Maritime Servioe with Dr. Cardoso. Dr. Cardoso has been abre to secure the right to prohibit the departure of sail boats from Reoife unless their water barrels are properljr protected against mosquitoes. Visit Ilha de Pinna and find one focus behind the guarda. Call on Mr. B t rAof the Great Western. noon an& Attend Congress in the sf'ter- Dr. Arag!Zo presents latest results in Yellow Fever Researoh. October 19th. To Olinda with Dr. Doyle. One focus behind the guarda and one wxth the guarda in thirty two houses visited. Olinda is being worked only on Saturdays although Dr. Wilson would prefer a regular service similar to that of the rest of Reoife. Preside at Dr. Fraga*s request at part of afternoon session of the Congress. Ball at the Government Palaoe. Dr. Davis does not appear, Dr. Burke appearing for a few moments only. October 20th. Leave Palaoe at 3.30 starting to Parahyba at 4.30. Sunday dinner with the Crawfords on the beach. Arrive in Reoife about 7 p.m. Dixaer at 17ilson* s. Ootober 21st. Lunoh with the 1915 Rio de Janeiro Nedioal Class. Wke arrangements for Dr. Agricola, Dr. Waldomiro and Dr. Placid0 Barbosa to visit our Servioe tomorrow. Rooha Lima presents a paper on Oroya Fever. Attend official conoert with Dr. Connor. October 22nd. Visit Yellow Fever Sarvioe with official guests. LlNl0h with Bath- and Mr. Jones. Inauguration of bust of Amaury Medeiros. Congress disct lssion of malsria papers very limited. Offioial closing of the Congress with oration, gloria a ti Perna&ouco by Dr. Antonio Barros Earreto and a counter oration by Dr. Alcides Figuereido of Nictheroy. Farewell dance at the Joc&y Club. October 23rd. Embark on "Arlama'* for Rio. October 24th. Dine in Bahia with Rockefeller contingent. October 28th. Arrive in Rio. FURTHER NOTES ON OCTOBER TRIP TO BAHIA AND RECIFE Professor Abreu Fialho, present Dean of the Medical School brings up the question once more of Foundation assistance to the B Institute which is being founded. Dr. Arthur Moises, it seems, is also very much interested in this project. As a matter of fact he discusses it more completel:; than does Professor Fialho. (Dr. Moises refuses to r&urn to Rio by air plane because of the impossibility of passing seventeen hours without talking.) Dr. Gouveskde Barros, my Brazilian godfather, shows but little change after the lapse of aTmost ten years. Be has been giving by far the best cooperation secured in the North. I assure him that I expect proper treatment from my godfathsr to 2my godchild, Dr. Rickard who is soon to go North. Dr. Cassio Miranda of S&o Luiz discusses and explains our financial difficulties. EverythinS is now apparently cleared up. Dr. Fontenellb says that he has been elected parampho of this year's g-b%%; class from the School of Nursing. He states that he and M5-s. Parsons are not now on speaking terms. He believed that it is because he has advocated having extern students in the School of Nursing. Dr. Barges Vieira says that Dr. Jayme Pereira has been attemp& in& to arrange a fellowship for Dr. Bento Ribeiro in S5o Paulo. It seems that Dr. Jayme has even trritten from the ?Inited States insisting that the fellowship is all arranged. Dr. Afranio &aral takes occasicn to reoognise mo and fishes for an invitation to visit the Yellow Fever Laboratory in Bahia. This I oannot very well do as Dr. Aragiio has been invited to pass some days at the Laboratory en route to Rek;n after the present Congress. v-l0 Dr. A.L. Barros Baraeto introduced a motion supE;orting the itIc& of a Fede:*al Ministry of Health. He maintained himself on the Exeoutivs Com3Gttee ir sp its of the @press desire that the Executive Co-mmi-%ee should be changed. This a&ion dPe'ju$tified as being Lhe wla?'i?o'us desird of the entire delegation from Bahia. CF descri:)os him as infantile. ZIe complains to CF on !;hc 3vc of departure from Recife that he has not bocn given a oabin de luxe on the "Arlansa" and insists that he is the ranking personality at the co:lgress. Dr. Fraga explains that the three cabins de luxe available were assigned to Dr. Fialho, Dr. Jo80 Barros Barr&o and himself and offers his cabin to A.LBB who accepts it! ALBB avoids speaking to me during the Congress and the return trip. MEC on October 23rd states that he ferls that RF has been belittle- the Congress, that RF should work nowhere. but -here it is duly appreoiated, that motion approving CF's -stork with YF was passed but no motion oonsiderivrg the work of the RF was oonsidercd. I take occasion to oontest this opinion since yellohr fever -fms not a subject for discussion at this Congress. It is true that AragEo 48. gave a paper, but this was an evening address, the same as that of Rooha Lima's on Oroy-a Fever. CF paid due tribute to Dr. Lewis and the RF in his opening address. The representative of the Found.-tion presided at one of the afternoon sessions of the Congress and sat at the Governorts right on the evening of Dr. Roaha Lima's oonferenoe. I, for one, feel that the RF received all the attention to be expeoted %EC has asked for six moh%hsl leave w5thou-k pay Plans on shifting CzgF& to BsMaLaboratory and has written to FFR that Bailey vi11 be left in Rio de Janeiro Office. - --VI COPY EWDACAO ROCKEFELLER Rio de Janeiro No.1714 30th December 1929 Dear Dr. Russell: On the 26th inst., I conferred with Dr. Fraga, more es- pecially as relating to our government budget for the year 1930. Fof the year 1929 from Earth to December the Government allowed us 5,OOO:OOO~OOO for yellow fever work in the Northern Zone. Of this amount we expended of less than 1;000:000~000, the exact figures will not be available until early in January. For 1930 I have requested the renewal of the 5,000:000$000 %d Dr. Fraga has approved of same. During the recent graduation exercises conducted by the School of Nursing, Dr. Fontenelle delivered an address, a paragraph of which emphasized that the Government would not renew its contract with the Rockefeller Foundation for financial and technical assist- ance to the school, and further that the American nurses now here would soon be replaced by Brazilians, '&bile the abov? statement summarizes our Division's policy as regards our cooperation with the School of h'ursing, the emphasis which Dr. Fontenelle placed on the statement r&s of such a nature as to give rise to the suspicion that perhaps his discourse was inspired; we do not have a signed agreement for the cooperation. I confer&d with Mrs. Parsons and she thought that I should try and ascertain from Dr. Fraga his attitude in this matter. I did so and he denied previous knowledge of Dr. Fontenelle's intentions, and furthermore, Dr. Fraga was most emphatic in assuring me that he was most anxious for our Division to continue cooperating k+tith the D.N.S.P. in the development of the School of Nursing. He stated t!-.at the ser- vices of I&-s. Parsons mere greatly appreciated and, while he didnot alwa::s see eye to eye with her in administrative details, he neverthe- less realized that the problem was complicated, at times very trying but progress`isbeing recorded. He is equally pleased with the ser- vices of the other American nurses. Dr. Fraga told me that the President would always find suf- ficient funds for yellow fever; also that the incoming President is pledged in favour of creating a Kinistry of Bealth. Dr. Fraga's friends are urging that he be appointed to this position, which he will accept if the invitation is extended. The occasion seemed to be opportune to approach the question of our Division's further cooperation in Brazil. I had in mind your frequent reference to a County Health Unit program on a large scale, On mentioning this to Dr. Fraga he immediately replied that his in- terest in public health matters lay first in seeking the eradic2tion of yellow fever from all Brazil; second, the completion of the Sao Sebastiao Rospital; third, that the yellow fever question definitely settled he would like to arrange a cooperative program w%th our Di- vision for the control of malaria in the capitals of the principal -2- 30th December 1929 states where this infection is a serious problem. I pointed out that a program on an extensive plan such as we are now oper- ating against yellow fev+:r would be a tremendous undertaking but that our Division is interested in the malarial problem and I would submit his suggestions. I think Dr. Fraga has in mind that our present organiza- tion will be in a position in one or txo years to lessen concen- tration against the stegomyia and to turn to anti-malaria measures. In several sectors, principally Bahia and Recife, we are actually reducing the malaria incidence through grass cutting, ditch- ing and sub-soil drainag.> p xork undertaken to reduce troublesome mos- quitoes. (Signed) Very sincerely yours, K. E. Connor Dr. F. F. Russell The Rockefeller Foundation New York City.