The Path Between the Seas

by David McCullough

Wherever or whenever it struck, it spread panic of a kind that could all but paralyze a community. It was a far more violent and hideous thing to see; a more gruesome way to die. The mortality rate among those who contracted the disease could vary enormously, from 12 or 15 percent to as much as 70 percent. Generally speaking, however, a yellow-fever patient in Panama in the 1880’s had a less than fifty-fifty chance of survival. As with malaria, the patient was seized first by fits of shivering, high fever, and insatiable thirst. But there were savage headaches as well, and severe pains in the back and the legs. The patient would become desperately restless. Then, in another day or so, the trouble would appear to subside and the patient would begin to turn yellow, noticeably in the face and in the eyes. In the terminal stages the patient would spit up mouthfuls of dark blood—the infamous, terrifying vómito negro, black vomit. The end usually came swiftly after that. The body temperature would drop, the pulse fade. The flesh would become cold to the touch—“almost as cold as stone and [the patient] continues in that state with a composed sedate mind.” Then, as a rule, in about eight to ten hours, the patient would die. And so great was the terror the disease generated that its victims were buried with all possible speed.