1. Pre-vaccination epidemiology 1700-1930 (page 1.1) The first account of a sickness that can definitely be recognised as yellow fever occurred in Guadeloupe and in Yukatan in 1648. Slave trade in the seventeenth century formed an intimate bond between West Africa and Spanish-Portuguese America. “Yellow Jack” was one of the most dreaded of the diseases of the Atlantic trade routes; the legend of the “Flying Dutchman”, a vessel doomed to haunt the seas around the Cape of Good Hope because yellow fever broke out and no port would give her harbourage and all the crew perished, as described by Sir Walter Scott, was inspired by stories of this disease. Lind’s account (1792) of fever aboard the vessel off the coast of Senegal in 1768 is usually accepted as the first in which we can definitely recognise yellow fever in Africa. No clinical description of the fever was given, but the evidence for its being yellow fever was its occurrence first in men who had been ashore, and its apparent propagation aboard ship. The first clinical report on yellow fever was published by Schotte in 1782 on the “Synochus Atrabiliosa” in Senegal in 1778: “...the vomiting continued... It became green, brown, and at last black, and was coagulated in small lumps... A continual diarrhoea, with gripings, now took place, by which a great quantity of black and putrid faeces were evacuated... The skin became now full of petechiae...”