Overview

Lesson Procedure

60-75 minutes of class time across 5 phases.

1. Warm-Up5-10 minutes
2. Direct Instruction20 minutes
3. Guided Practice15 minutes
4. Independent Practice15-20 minutes
5. Closure5-10 minutes

1. Warm-Up5-10 minutes

   Read the prompt aloud and give students three minutes to write. The situation is invented for this warm-up.

   Warm-Up Prompt

   "A school installs new water fountains in September and starts a hand-washing campaign in October. By December, absences for illness are down by half compared with last year. The principal's newsletter says the fountains did it. You have the newsletter, the attendance table and a nurse's log. What would you check in each source before you agreed? What could none of them tell you?"

   Collect answers. Students usually notice that the two changes happened together, that last year may have had an unusual illness, and that the principal chose the fountains. Name the skill: RH.11-12.7 asks students to integrate sources in different formats and media (words, numbers, visuals) and to evaluate them, in order to address a question or solve a problem. The question comes first; the sources are judged by how well they answer it.

2. Direct Instruction20 minutes

   Part 1: The question and the first sources. Write the question on the board: What ended yellow fever in Havana in 1901? Read T1, Gorgas's account of the cleanup, and show Table 1 and Diagram 1. Gorgas was not a neutral observer: he ran the health department whose work he describes, and he wrote in 1915, after his success in Panama had made him famous. Black vomit (T3) is a period name for a late symptom of yellow fever, vomiting of digested blood; non-immune means a person who has never had the disease, since one attack gave lasting protection.

   1Being immune to yellow fever, I made application to go with the troops that took possession of Havana. We arrived there in December, 1898. The military authorities concluded that this was the opportunity which the United States had been awaiting for the past two hundred years. Thinking that yellow fever was a filth disease, they believed that if we could get Havana clean enough, we could free it from yellow fever. It was felt that if we could eliminate Havana as a focus of infection, the United States would cease to be subject to epidemics. This meant so much to the United States, financially and otherwise, that the authorities determined to make all other efforts secondary to this sanitary effort.

   2The city was cleaned as well as it was possible to cleanse it. This remark applies as well to the private premises as to the public highways. Energetic and capable Army officers were placed at the head of various municipal departments, and these departments were thoroughly organized and made as efficient as possible. By the middle of the year 1900 all the city governments were perfectly organized, and were accomplishing all that it was possible for them to accomplish. I believe that Havana was cleaner than any other city had ever been up to that time.

   3The health regulations of the Sanitary Department, such as the isolation and care of yellow-fever patients, were thoroughly and carefully carried out. But in spite of all this work and care, yellow fever had been steadily growing worse ever since we had taken possession of the city, and in 1900 there were a greater number of cases than there had been for several years. The Cubans twitted us with the fact that all our cleaning up and expenditure not only had not bettered things, but had even made them worse. They called attention to the fact that the very cleanest and best kept portions of the city were by far the worst sufferers from yellow fever, and the evidence was so staringly before our eyes that we had to acknowledge the truth of what they said.

   4The health authorities were at their wits’ end. We evidently could not get rid of Havana as a focus of infection by any method we then knew.

   Table 1. Deaths from yellow fever in the city of Havana, 1890-1901, as printed by Gorgas (Sanitation in Panama, 1915, chapter VI). The figures are deaths recorded in the city, not cases.

   Year	1890	1891	1892	1893	1894	1895
   Deaths	308	356	357	496	382	553

   Table 1 (continued), 1896-1901. American troops took control of Havana in December 1898 and January 1899.

   Year	1896	1897	1898	1899	1900	1901
   Deaths	1,282	858	136	103	310	18

   • Testing a written claim against the table (T1 paragraph 3, Table 1)

     T1: "yellow fever had been steadily growing worse ever since we had taken possession of the city, and in 1900 there were a greater number of cases than there had been for several years." Table 1: 136 deaths in 1898, 103 in 1899, 310 in 1900; 1,282 in 1896 and 858 in 1897.

     Result: The table supports only part of the first half: deaths fell from 136 in 1898 to 103 in 1899, the first year of American control, and then roughly tripled in 1900 (310 / 103 is about 3.0), so the rise was sharp but not "steadily" from the start. The second half is harder to check. Gorgas speaks of cases, and the table counts deaths; measured in deaths, 1900 was worse than 1898 and 1899 but far below 1896 and 1897. Integrating the two sources narrows the claim to what both support: yellow fever rose sharply during the cleanup, even though 1900 was not the worst year of the decade.

   • Evaluating the table itself (Table 2)

     Table 2 prints each year's months and a total. For 1897 the months are 69, 24, 30, 71, 83, 174, 168, 102, 56, 42, 26 and 8, and the printed total is 858.

     Result: The months add to 853, five fewer than the printed total; the other four years add up exactly. A small error in a printed table does not change the pattern, since 853 and 858 tell the same story, but it shows why a careful reader checks totals before building an argument on them, and why a table is a source with a maker, not a window on the facts. For an answer about 1901, the monthly figures matter more than the annual totals, because they show when in the year the deaths fell.

   Table 2. Deaths from yellow fever in Havana by month, 1897-1901, as printed by Gorgas (chapter VI). The bottom row is the total as printed. Directly below the table Gorgas writes: "In February, 1901, the measures above described were begun."

   Month	1897	1898	1899	1900	1901
   January	69	7	1	8	7
   February	24	1	0	9	5
   March	30	2	1	4	1
   April	71	1	2	0	0
   May	83	4	0	2	0
   June	174	3	1	8	0
   July	168	16	2	30	1
   August	102	16	13	49	2
   September	56	34	18	52	2
   October	42	26	25	74	0
   November	26	13	18	54	0
   December	8	13	22	20	0
   Total (printed)	858	136	103	310	18

3. Guided Practice15 minutes

   Read T2 and T3, Gorgas's account of the experiments of the Army board led by Walter Reed at Camp Lazear, near Havana, in late 1900, and T4, his account of the measures his department began in February 1901. Stegomyia was the name then used for the yellow-fever mosquito, today called Aedes aegypti; larvae are young mosquitoes, which live in water before they fly. Show Diagram 2. Pairs answer two questions before the class works the examples: What exactly did each experiment test? What did the department do in 1901, and in what order?

   1He had a small frame house built, fourteen by twenty feet, well screened-in with wire netting, so that mosquitoes could not get in or out. This building he had divided into two compartments by a partition extending down the center, made of wire netting, and it was known as the infected mosquito building. It was well ventilated. Most persons at this time believed that in some way the air conveyed yellow fever. Dr. Reed wished to show that this was not the case.

   2He put two non-immunes in this building, one in each room. These two men breathed exactly the same air, and had exactly the same surroundings, with one single exception which I will in a moment point out. But they were entirely separated by the wire netting. He let them live and sleep in these rooms for several days, so as to demonstrate that there was no yellow-fever infection in the building. He then put fifteen infected stegomyia in one of the rooms; left the man in this room for thirty minutes, announcing that the room was now infected. He took the man out of this infected room, but left in the other room two men on the other side of the wire netting. He stated that the man who had stayed thirty minutes in the infected room would come down with yellow fever within three or four days, and that the other men, who were only separated from him by wire netting, and who breathed and were surrounded by exactly the same air, would not get sick.

   3He explained that the only difference between the two rooms was that in the infected room, infection had been brought about by liberating there fifteen stegomyia mosquitoes which had previously bitten patients sick of yellow fever. The man from the infected room was on the afternoon of the same day again placed in this room for twenty minutes, and on the following day he was a third time put in the room for fifteen minutes. On the first visit he was bitten by seven mosquitoes; on the second, by five; on the third, by three. At the end of the fourth (Christmas) day, Reed showed the man from the infected room down with yellow fever, and the men who had lived and slept in the other room, separated only by wire netting, perfectly well. He called attention to the fact that the only difference in the exposure of these men was that the sick man had been in a room for thirty minutes, with fifteen infected stegomyia mosquitoes. He claimed that this was a demonstration that the female stegomyia mosquito could transmit yellow fever, and that the atmosphere alone could not. Many of the visitors to Dr. Reed’s camp were clinically familiar with this disease, and the case was sufficiently marked to be easily recognized by all as being a case of yellow fever.

   4Dr. Reed then announced that he would disinfect the room so that it would no longer give yellow fever. When it was prepared, he again placed a non-immune in each room, left them there for several days, and they remained perfectly well. He explained that he disinfected the room by simply catching all the stegomyia mosquitoes which he had formerly liberated in the room.

   1This demonstration made a very profound impression. Many, however, still urged that while it was evident that the female stegomyia mosquito could convey yellow fever, it was equally evident from the history of epidemics of this disease that it could be and was generally conveyed in other ways, such as soiled clothing, bedding, the bodies of yellow-fever dead, persons sick of the disease, etc.

   2Dr. Reed had a small house built, made almost air-tight and with scarcely any ventilation. This building was known as the infected-clothing building, and was purposely so constructed as to exclude anything like efficient ventilation. It was placed on the opposite side of a small valley, about eighty yards from the infected mosquito building, and they were both about seventy-five yards distant from the camp proper. Both houses were provided with wire screen windows and double screen doors, so that mosquitoes could be kept without or within the building, as the experimenter might desire.

   3In this building he placed material obtained from Las Animas, the yellow-fever hospital of the Health Department of Havana; mattresses on which yellow-fever patients had died, soiled by their excreta and discharges; sheets, pillows and pillow-cases stained with black vomit; the pajamas which patients had worn at the time of their death. It was Dr. Reed’s desire to have this material infected if it were possible to become infected in this way. Dr. John W. Ross, the superintendent of Las Animas Hospital, therefore gave the matter his personal attention, saw to the packing of this material in chests for transportation to Camp Lazear, and before the chests were closed, had basins of black vomit and other excreta from yellow-fever patients poured over the contents of the chest. If there were any possibility of such material becoming infected, infection certainly would have followed such procedure.

   4Dr. Reed had this material opened up and spread out in the close room I have described. He called for volunteers to sleep in this room. Dr. R. P. Cook of the Army, and several soldiers quickly responded. These men put on the pajamas soiled as described, and slept on the mattresses and bed clothing soiled beyond description. For a period of twenty days they spent the nights in this building, but for the sake of general health were allowed to go out during the day. All the men remained perfectly well, and no case of yellow fever was developed from such exposure.

   5This set of experiments was generally accepted as proving that yellow fever was conveyed from man to man by the mosquito alone, and that it was not transmitted in any other way. A great many persons, however, were still skeptical. The experimental camp had been named “Lazear” in memory of Dr. Lazear, a member of the Board, who had died a few months before of yellow fever, contracted while prosecuting this work.

   1The Army Board had demonstrated that the mosquito, to become infected, had always to bite some patient with yellow fever within the first three days of his disease. It was evident, therefore, that if we could prevent this being done in every case of yellow fever in Havana, the disease would disappear. This measure alone would be sufficient for eliminating yellow fever.

   [...]

   2From our general knowledge of the life history of all species of mosquitoes, we knew they had to spend eight or nine days in a larval stage, and that while in this larval stage they lived in water. Therefore, collections of water were necessary for the development of the mosquito. The stegomyia mosquito we knew preferred clear, clean water, such as is supplied by the various collections of rain water needed for domestic purposes. The city of Havana had pipe water over only a small portion of its area. By far the larger portion of the population obtained its water supply from rain water stored in cisterns, tanks and receptacles of all kinds. We resolved to stop mosquito-breeding in all such places.

   [...]

   3It is very surprising and impressive to see how rapidly such a system will free a city of mosquitoes, and how after a few months of such work you cease to be annoyed by them. In yellow-fever work this system of destroying mosquito larvæ is the essential; everything else is secondary to it. In the built-up portions of a city such as Havana, caring for the cisterns, water barrels and containers is the essential work, but as you approach the suburbs, pools and puddles become more frequent, and this character of mosquito breeding-places becomes more important than containers. Wherever possible these breeding-places should be drained, though oiling in this class of work has a very useful field. In the suburbs, in these pools and puddles, the anopheles, the malarial mosquito, becomes common and this disease has to be looked after. We had fifty men engaged in this work, under a different set of inspectors from those doing the stegomyia work. This was made necessary, as the men doing the anopheles work were occupied almost entirely in the suburbs of the city. The details I will describe in another place.

   • Evaluating an experiment as evidence (T2 paragraphs 2-4)

     T2: two non-immunes "breathed exactly the same air," separated only by wire netting; fifteen infected mosquitoes were released in one room; the man there was bitten "by seven mosquitoes; on the second, by five; on the third, by three," and by "the end of the fourth (Christmas) day" he had yellow fever, while the men in the other room stayed "perfectly well." After the mosquitoes were caught, two more non-immunes stayed in the room and "remained perfectly well."

     Result: The design is strong because it changes one thing: same building, same air, and only one room has infected mosquitoes (7 + 5 + 3 = 15 bites). It also runs the test backward: remove the mosquitoes and the room is safe. Its limits are just as clear: the main trial has one sick man, and Gorgas is retelling it, not reporting it; he even says first that there was one man in each room and then that "two men" stayed in the other. The experiment shows that mosquitoes can carry yellow fever. It cannot, by itself, show what ended the disease in a city of 250,000.

   • Month by month: comparing the same season (Table 2, Diagram 2)

     Table 2: July-December 1900: 30, 49, 52, 74, 54 and 20 deaths. July-December 1901: 1, 2, 2, 0, 0 and 0. January-February 1901: 7 and 5. Gorgas's sentence below Table 2 dates the start of the measures to February 1901.

     Result: In every year of Table 2 before 1901, deaths were far fewer from January to April than from July to October, so the fair comparison is season against season. July-December 1900 had 30 + 49 + 52 + 74 + 54 + 20 = 279 deaths; the same months of 1901 had 5, a drop of about 98 percent. January and February 1901, before the measures began, look like January and February 1900 (12 against 17). The chart and the table together place the collapse in the first yellow-fever season after the measures began, which is the pattern the mosquito explanation predicts.

   • When the sources cannot separate the causes (T4, Table 2)

     T4 paragraph 1: preventing mosquitoes from biting patients "alone would be sufficient for eliminating yellow fever." Paragraph 2: "We resolved to stop mosquito-breeding in all such places." Paragraph 3: "this system of destroying mosquito larvae is the essential; everything else is secondary to it."

     Result: In 1901 the department screened patients, fumigated houses and destroyed larvae at the same time, so Table 2 can show that the combination worked but not which part did the work. T4 even contains two claims that pull against each other: one measure "alone would be sufficient," and another is "the essential." Which measure mattered most is a judgment the Havana figures cannot settle, and a strong answer says so.

4. Independent Practice15-20 minutes

   Students read T5, T6 and T7. T5 returns to Havana in February 1901; T6 and T7 follow the question to Panama City, where Gorgas became chief sanitary officer in 1904, and where yellow fever broke out among canal workers in 1905. The Isthmian Canal Commission ran the American project from Washington; John F. Wallace was its chief engineer in 1904-1905. Insect powder is dried pyrethrum flowers, burned to stun or kill insects. Students add each source to their evaluation grid from Activity 1, then take the quiz, which uses T5-T7 with T1-T4, the tables and the diagrams.

   1At this time, February, 1901, I was health officer of the city of Havana. The efforts of the Department had been concentrated for more than two years previous upon controlling yellow fever in that city. Not only had we met with no success, but yellow fever was actually worse than when we commenced work. Ample funds and power had been given us by General Wood, the military governor, and we had by far the best and most efficient sanitary organization of whose existence, either before or since that time, I have any knowledge.

   2When the work of the Reed Board began to point to the mosquito as the conveyor of yellow fever, the Sanitary Department of Havana was at its wits’ end and was glad to receive this discovery as a means of possible help. I, as health officer of Havana, had nothing to do with the work of the Reed Board in any way whatever, except that I was a very interested spectator and kept in close touch with the work as it developed. We assisted the Board in every way that we could. All the hospitals in the city were under our control, so that we were enabled to furnish them ample clinical material.

   3Neither the Reed Board nor any of its members had anything to do with the practical working out of the methods whereby their theory was demonstrated, and by means of which yellow fever was finally eliminated from Havana. These methods were first originated and worked out by the Sanitary Department of Havana during the year 1901. They have since been copied and successfully applied in many parts of the world where yellow fever formerly prevailed.

   1As I have mentioned in a former chapter, when we got through at Havana, we all thoroughly believed that the great virtue of our work there lay in the killing of infected mosquitoes by fumigation. So when we commenced work in the city of Panama, we relied principally upon this method. We carried fumigation in Panama, however, much further than we had ever dreamed of doing at Havana. Beside carrying out the method which we had developed at Havana of fumigating the house where a case of yellow fever had occurred, together with all the contiguous houses, we adopted the following plan.

   2Panama compared with Havana was a very small town. Havana in 1904 had a population of 250,000; Panama, about 20,000. Instead of waiting for the slow process of fumigating the house where a yellow-fever case occurred, with the contiguous houses, and thereby killing the infected mosquitoes concerned in that particular case, we ought to be able, we said, in a small town like Panama to fumigate every house in the city within a comparatively short time, and thereby get rid of all the infected mosquitoes at one fell swoop.

   3This would certainly have been the result if our premises had been correct, namely, that it was the fumigation that had caused the disappearance of yellow fever at Havana. With this object in view, we commenced at one end of the city and fumigated every building. It took us about a month to get over the whole town. Cases of yellow fever still continued to occur after we had finished. We therefore went through the procedure a second time. Still other cases occurred, and we went over the city a third time. We used up in these fumigations in the course of about a year some hundred and twenty tons of insect powder, and some three hundred tons of sulphur. These quantities of material give some idea of the amount of fumigation.

   4This draft of one hundred and twenty tons of insect powder represented the whole supply of the United States for a year, and we actually used up at Panama all the insect powder that could be found in the market of the United States.

   [...]

   5During the fall of 1905 yellow fever rapidly decreased, and by November, the last case of this disease had occurred in Panama. This fact quieted alarm on the Isthmus, and gave the sanitary officials great prestige, not only among the now large body of Canal employees, but also among the native population living on the Isthmus.

   1No man suffered more from this sort of official delay and stupidity than did Col. Gorgas. If any man was fighting for life it was he--not for his own life but that of the thousands who were working, or yet to work on the canal. Yet when he called for wire netting to screen out the malarial mosquitos he was rebuked by the Commission as if he were asking it merely to contribute to the luxury of the employees. The amount of ingenuity expended by the Commission in suggesting ways in which wire netting might be saved would be admirable as indicative of a desire to guard the public purse, except for the fact that in saving netting they were wasting human lives. The same policy was pursued when appeals came in for additional equipment for the hospitals, for new machinery, for wider authority. Whenever anything was to be done on the canal line the first word from Washington was always criticism--the policy instantly applied was delay.

   [...]

   2At the moment that cable message was sent Panama was shuddering in the grasp of the last yellow fever epidemic that has devastated that territory. Perhaps had Col. Gorgas secured his wire netting earlier, or Wallace’s appeals for water pipes met with prompter attention it might have been averted. But in that May and June of 1905 the fever ravaged the town and the work camps almost as it had in the days of the French. There had been, as already noted, some scattered cases of yellow fever in the Zone when the Americans took hold, but they were too few and too widely separated to cause any general panic. The sanitary authorities however noted with apprehension that they did not decrease, and that a very considerable proportion were fatal. It was about this time that the Commission was snubbing Col. Gorgas because of his insatiable demands for wire screening. In April there were seven cases among the employees in the Commission’s headquarters in Panama. Three died and among the 300 other men employed there panic spread rapidly. Nobody cared about jobs any longer. From all parts of the Zone white-faced men flocked to the steamship offices to secure passage home. Stories about the ravages of the disease among the French became current, and the men at work shuddered as they passed the little French cemeteries so plentifully scattered along the Zone.

5. Closure5-10 minutes

   Exit ticket: On an index card, answer the lesson's question in two sentences. Name the one source you relied on most and one limit of that source.

   Teacher note on the sources and their language: Gorgas and Abbot are quoted exactly as printed in 1915 and 1913, including period spellings (larvae printed as larvæ) and period names for the disease. Both books use dated racial terms, and Abbot's also contains slurs and demeaning descriptions of Black laborers, in passages not printed here; one clause in T8 that uses a dated term for Black laborers is cut and marked [...], and its content is summarized in the text's note. The page does not reproduce slurs. Both authors wrote to praise the American work: Gorgas was its leader, and Abbot's book celebrates the canal. Remind students that the idea of mosquito transmission came from the Cuban physician Carlos Finlay, whom the Reed board credited, and that the volunteers in the experiments risked their lives; one board member, Jesse Lazear, died of the disease.

   Homework passages. T8 gives several estimates of French deaths in the 1880s, and T9 is Gorgas's calculation of what sanitation saved during the American construction. Use them for the homework problems.

   1Col. Gorgas tells of a party of eighteen young Frenchmen who came to the Isthmus, all but one of whom died within a month. The Mother Superior of the nursing sisters in the French hospital at Ancon lost by fever twenty-one out of twenty-four sisters who had accompanied her to the Isthmus.

   2How great was the total loss of French lives can only be guessed. The hospital records show that at Ancon, 1041 patients died of yellow fever. Col. Gorgas figures that as many died outside the hospital. All the French records are more or less incomplete and their authenticity doubtful because apprehension for the tender hopes and fears of the shareholders led to the suppression of unpleasant facts. The customary guess is that two out of every three Frenchmen who went to the Isthmus died there. Col. Gorgas, who at one time figures the total loss during the French régime at 16,500, recently raised his estimate to 22,000 [...]. Little or no effort was made to induce sanitary living, as under the Americans, and so ignorant were the French--as indeed all physicians were at that time--of the causes of the spread of yellow fever, that they set the legs of the hospital beds in shallow pans of water to keep the ants from creeping to the beds. The ants were stopped, but the water bred hosts of wrigglers from which came the deadly stegomyia mosquito, which carries the yellow-fever poison from the patient to the well person. Had the hospital been designed to spread instead of to cure disease its managers could not have planned better.

   1Our Army in Cuba during the Santiago campaign had during the last two months of our stay there a constant sick rate of over six hundred per thousand. Undoubtedly, the French rate approximated this during their period of active work, and we can safely calculate that their constant sick rate was at least three hundred and thirty-three per thousand, or one-third their force.

   2Our force during the ten years of construction averaged thirty-nine thousand men. If we had had a similar constant sick rate, we should have had thirteen thousand sick employees in our hospitals every day during the ten years of construction. As it was, we had only twenty-three per thousand sick each day, a total of nine hundred for the whole force; that is, we had about twelve thousand fewer men sick every day than had the French. This twelve thousand men per day saved from sickness must be credited to the sanitary work done on the Isthmus.

   3Now let us consider the totals: We had an average of 900 men sick every day. For the year, this would give us 328,500 days of sickness, and for the ten years 3,285,000 days of sickness. If our rate had been 300 per 1,000, a very moderate figure compared with what it was under the French, we should have had 11,700 sick every day. For the year, this would have given us 4,270,500 days of sickness and for the ten years, 42,705,000, a saving of 39,420,000 days of sickness during this period. This saving must justly be credited to sanitation.

   4It cost us about one dollar a day to care for a sick man on the Isthmus. The Commission cared for the sick free of charge. Every day, therefore, of sickness prevented on the Isthmus lessened the expense which the Commission had to bear by one dollar. The Commission was therefore saved by this sanitary work, if we consider the whole ten years of construction, $39,420,000.

Differentiation Strategies

Assessment Guidance

1. Question 1 of 20 · Multiple Choice

   According to T5 paragraph 1, what had the Havana health department's work achieved by February 1901?

   AYellow fever deaths had fallen by half since 1899 BNo success; it was worse than when work began CSuccess in the city center but not the suburbs DAn end to yellow fever except among newcomers

2. Question 2 of 20 · Multiple Choice

   In T5 paragraph 1, Gorgas says his department had "by far the best and most efficient sanitary organization" he had ever known. Why does this detail matter to his argument?

   AIt shows the department had too little money to act BIt proves the Reed board's theory was correct CIt explains why the Cubans praised the cleanup DIt rules out weak effort as the cause of failure

3. Question 3 of 20 · Multiple Choice

   In T5 paragraph 3, Gorgas writes that "Neither the Reed Board nor any of its members had anything to do with the practical working out of the methods" that eliminated yellow fever. Why should a reader weigh this claim with particular care?

   AGorgas led the department he gives the credit to BGorgas was himself a member of the Reed Army board CTable 2 shows that the methods did not work DCarlos Finlay, not Gorgas, wrote the passage

4. Question 4 of 20 · Multiple Choice

   T5 paragraph 2 says Gorgas was "a very interested spectator" of the Reed board's work. How should this affect the way you use T2 and T3?

   AReject them, since Gorgas could not know what happened BTrust them fully, since Gorgas had no stake in them CTreat them as a close observer's retelling to check DUse them only for their numbers and ignore the events

5. Question 5 of 20 · Multiple Choice

   According to T6 paragraph 1, what premise did Gorgas's department carry from Havana to Panama?

   AThat destroying larvae was the essential measure BThat fumigating houses had ended the disease CThat cleaning the streets would end yellow fever DThat screening patients alone would be sufficient

6. Question 6 of 20 · Multiple Choice

   Using the figures in T6 paragraph 2, about how many times as many people lived in Havana as in Panama in 1904?

   AAbout 1.25 times BAbout 11.5 times CAbout 12.5 times DAbout 0.08 times

7. Question 7 of 20 · Multiple Choice

   In T6 paragraph 3, cases of yellow fever "still continued to occur" after Panama was fumigated a third time. What does Gorgas take this to show?

   AThat Panama had too many houses to fumigate BThat the insect powder had been of poor quality CThat Panama's disease differed from Havana's DThat fumigation was not what saved Havana

8. Question 8 of 20 · Multiple Choice

   T4 calls destroying larvae "the essential," while T6 says that after Havana "we all thoroughly believed" fumigation had done the work. What best explains the difference?

   AT4 is Gorgas's view by 1915; T6 is his belief in 1904 BT4 is about Panama in 1905 and T6 is about Havana in 1901 CT4 is by Walter Reed and T6 is by William Crawford Gorgas DThe two passages describe two different tropical diseases

9. Question 9 of 20 · Multiple Choice

   How does Abbot's account of the 1905 epidemic (T7 paragraph 2) differ from Gorgas's in T6?

   AAbbot blames fumigation, and T6 blames the Commission's delays BAbbot cites delayed screens and pipes; T6, failed fumigation CBoth blame the French hospitals left on the Isthmus DAbbot says the epidemic never reached the work camps

10. Question 10 of 20 · Multiple Choice

    What kind of claim is Abbot's sentence "Perhaps had Col. Gorgas secured his wire netting earlier ... it might have been averted" (T7 paragraph 2)?

    AA count taken from the Commission's own records BA quotation from Gorgas's official report of 1905 CA conclusion proved by the April figures that follow DA hedged guess about what might have happened

11. Question 11 of 20 · Multiple Choice

    T7 reports that in April 1905 "there were seven cases among the employees in the Commission's headquarters in Panama. Three died." About what share of those cases died?

    AAbout 43 percent BAbout 57 percent CAbout 2.3 percent DAbout 1 percent

12. Question 12 of 20 · Multiple Choice

    According to Table 1, Havana's yellow-fever deaths in 1901 were about what percent of the deaths in 1900?

    AAbout 94 percent BAbout 5.8 percent CAbout 17 percent DAbout 0.58 percent

13. Question 13 of 20 · Multiple Choice

    Table 1 shows only 136 deaths in 1898 and 103 in 1899, before any mosquito work. Why does this matter for the lesson's question?

    AIt proves the cleanup ended yellow fever in 1899 BIt shows the table's figures for those years are false CSo one low year cannot prove the 1901 measures worked DIt shows yellow fever had ended before the Americans came

14. Question 14 of 20 · Multiple Choice

    What did the infected-clothing building (T3) test, and what did it show?

    AWhether soiled bedding spreads the disease; it does not BWhether infected mosquitoes carry yellow fever; they did CWhether fresh air prevents yellow fever; it did DWhether the blood of patients carries yellow fever; it did

15. Question 15 of 20 · Short Answer

    Rank four sources, T2, T3, Table 2 and T5, from most to least useful for deciding whether mosquitoes, rather than dirt or soiled things, carried yellow fever. Justify your first and last choices.

    Show model answer

16. Question 16 of 20 · Short Answer

    Integrate T6 and T7: what do the two accounts together suggest about the Panama epidemic of 1905, and which gives stronger evidence for its cause?

    Show model answer

17. Question 17 of 20 · Short Answer

    Is Gorgas a trustworthy source for the lesson's question? Give one reason to trust him and one reason for caution, each supported by a quotation from T1, T5 or T6.

    Show model answer

18. Question 18 of 20 · Short Answer

    What might a reader wrongly conclude from Diagram 1 alone about the American cleanup that began in December 1898? Which source on this page corrects that conclusion, and how?

    Show model answer

19. Question 19 of 20 · Short Answer

    Using at least one number from T2 and one from T3, explain why the two Camp Lazear experiments together are stronger evidence than either alone.

    Show model answer

20. Question 20 of 20 · Short Answer

    In T1, the Cubans "twitted" the Americans that cleaning had "even made them worse," pointing out that "the very cleanest and best kept portions of the city were by far the worst sufferers." Use Table 1 and T4 paragraph 2 to evaluate the Cubans' claim.

    Show model answer

These standards connect to RH.11-12.7: prerequisites to review first, parallel standards at the same level, and next steps that build on it.

Standard text: Common Core State Standards for English Language Arts & Literacy. © Copyright 2010. National Governors Association Center for Best Practices and Council of Chief State School Officers. All rights reserved.