All his experiments had failed: See Pierce and Writer, p. 149, who say that at this point Lazear was about ready to give up.
“harmless”: This quotation and the description of the encounter come from Agramonte’s “The Inside Story,” chap. 2, p. 3.
‘Yellow fever”. . .“Don’t be a . . . fool”: The exchange between Carroll and Pinto is reported by Bean, p. 130, whose exhaustive research included interviews with descendants of many of the participants. I have also used Crosby’s account of the incident.
8. Delirious?
Early in the morning: My description of this incident is derived from Agramonte, “The Inside Story,” chap. 2, pp. 3–4.
fewer white cells . . . organisms that caused the illness: The information on white blood cells comes from Downs, p. 452. I am also grateful to Dr. Martha Sonnenberg (e-mail communication Apr. 19, 2007) for helping me to understand how difficult it might have been for James Carroll to diagnose malaria when he peered through the microscope that morning.
“caught cold”: Agramonte, “The Inside Story,” chap. 2, p. 4.
In a state bordering on panic: Agramonte in “The Inside Story,” chap. 2, p. 4, says he and Lazear were almost “panic-stricken.”
‘You still fooling with mosquitoes”: The dialogue and the description of the incident come from Agramonte’s “The Inside Story,” chap. 1, p. 2. Some people, however, have disputed the truth of Agramonte’s account, which was written after Carroll and Lazear had died. Carroll, who apparently disliked Agramonte, once said that Agramonte knew nothing about the earliest mosquito experiments. Truby in his Memoir of Walter Reed, p. 119, says he believes Lazear would never have allowed Dean to volunteer for the experiments without explaining the potential dangers to him. The truth, however, will never be known unless other documents come to light.
“Patient delirious”: Warner, p. 1.
9. “Did the Mosquito Do It?”
“I cannot begin to describe”; “Can it be that”: Both quotations from a letter written by Walter Reed to Jefferson Kean, Sept. 6, 1900.
“My Dear Carroll”: Letter from Walter Reed to James Carroll, Sept. 7, 1900, quoted in Hemmeter, p. 162, and Crosby, p. 160. Crosby gives a fuller rendering.
“I rather think”: Fragment of letter written by Jesse Lazear, Sept. 8, 1900.
10. “Doctor, Are You Sick?”
big lab notebook . . . smaller book: The big lab notebook can still be seen at the New York Academy of Medicine. The smaller notebook was given to Reed after Lazear died, but it disappeared after Reed’s own death.
“Guinea pig No. 1”: Log Book of the Yellow Fever Commission, p. 100.
Nobody will . . . ever know: It is possible that the answers to some of these questions were contained in Lazear’s small lab notebook, which later disappeared. In the absence of concrete evidence, however, many people have tried to guess why Lazear might have lied about the bite. Pierce and Writer have suggested that Lazear concealed it because Reed may have ordered the young man to stop all human experiments after Carroll’s illness. I have not mentioned this theory in the text because, first, there is no evidence that Reed actually did this, and, second, because in the light of Reed’s later willingness to engage in human experiments, it seems unlikely that he would have issued such an order. Another theory states that Lazear might have been afraid his insurance company would have canceled benefits if they had known that he was risking his life in these experiments. I have mentioned this possibility even though Altman points out that there is no evidence that Lazear owned such a policy because the theory seems to make sense and because there is also no proof that Lazear did not own this type of policy. I do think it is possible that Lazear didn’t want his family to know that he was risking his life, and I also wonder if Lazear’s colleagues knew more about his “secret” than they ever said.
“nervous”; “flushed”; eyes were red: The dialogue and description of this incident all come from Kissinger, p. 4. Truby, Memoir of Walter Reed, p. 117, says that Lazear did not work late, but both Kissinger and Lazear’s nurse, Lena Warner (quoted in Kelly, Walter Reed and Yellow Fever, p. 236), stated that Lazear was up all night writing reports. I have followed their accounts.
“I can but believe”: Letter from Walter Reed to James Carroll, Sept. 24, 1900.
flash of panic: for documentation of this incident see Kelly, Walter Reed and Yellow Fever, p. 284, and a letter from James Carroll to Caroline Latimer dated Mar. 9, 1905.
8:45 that evening: Some writers have stated that Lazear died at 8:45 a.m. This, I believe, is due to a misreading of the entry on Lazear’s temperature chart in the Hench Collection at the University of Virginia.
“Dr. Lazear died”: Telegram from Jefferson Kean to Mabel Lazear, Sept. 26, 1900, in the Hench Collection at the University of Virginia.
11. Sorting It Out
“terribly depressed”: Truby, Memoir of Walter Reed, p. 116. Truby’s assessment of Reed’s feelings has weight because the two men were in contact during the period immediately following Lazear’s death.
first two cases didn’t “prove”: Letter from Walter Reed to James Carroll, Sept. 24,1900; Reed’s italics.
“My man”: The quotations and the description of this interview are taken from Truby, Memoir of Walter Reed, p. 122. Truby knew Walter Reed and was stationed at Camp Columbia at the time of this incident.
germs had to stay in the mosquito’s body: Scientists now know that after the mosquito sucks in the yellow fever germ, a series of changes takes place in the insect’s cells over the course of seven to seventeen days that allow the germ to enter the mosquito’s salivary glands (the glands that produce saliva). When the mosquito bites again, it pumps this germ-laden saliva into its new victim. The germ can also enter the mosquito’s eggs during this period, and that allows the bug to pass on the infection to a new generation of insects.
“General Wood”: The description of this incident and all quotations come from Jefferson Kean’s account of the meeting with Wood, in Blossom Reed, p. 5.
two hundred and fifty thousand dollars: This calculation was done through E.H. Net Economic History Service.
“From our study”: Reed et al., “The Etiology of Yellow Fever: A Preliminary Note,” p. 53.
“pure speculation”: Bean, p. 143, quoting the Philadelphia Medical Journal.
“Of all the silly”: Anon., “The Mosquito Hypothesis.”
12. Problems
tried to cheer him up: The description of this incident comes from Truby, Memoir of Walter Reed, pp. 143–44. Truby was with Reed at lunch that day and was one of the young doctors who went bug hunting.
dosed unsuspecting patients with disease germs: Experimenting on unsuspecting patients was quite common a century ago. Pierce and Writer, p. 175, note, for example, that Sanarelli didn’t get permission from his experimental subjects and that three of those individuals died after being injected with Bacillus icteroides. It is also interesting to note that although physicians have long believed in the principles of the two-thousand-year-old Hippocratic Oath (which asks doctors to swear that they will not deliberately harm a patient), history shows that physicians have also struggled to balance this belief with the fact that it is necessary to endanger a few lives in order to discover a fact that may save thousands. Dr. Lawrence Altman in Who Goes First, p. 15, sums up this problem by pointing out that “a literal interpretation” of the Hippocratic Oath would put a stop to most medical research.
“deliberately injecting a poison”: Altman, p. 135, quoting William Osier in “Discussion of G.M. Sternberg, The Bacillus Icteroides (Sanarelli) and Bacillus X (Sternberg).”’ Transactions of the Association of American Physicians 13 no. 71: (1898).
he wanted to do something new: Walter Reed’s belief that all volunteers should be fully informed of the risks before participating in scientific experiments has had an important effect on medical research. Today, thanks in part to Reed’s work, the thousands of people who help U.S. doctors test new dr
ugs and treatments are legally required to sign a form that specifically explains the possible dangers before taking part in any experiments.
13. “We Are Doing It for Medical Science”
$2,400: This calculation was done through E.H. Net Economic History Service.
“Just think, Johnny”: All quotations and the account of this incident have been derived from Moran, “Memoirs of a Human Guinea Pig,” pp. 7–9, and Moran, Draft fragments: “Walter Reed’s Human Guinea Pigs,” p. 3.
“I take my hat off’; “I salute you”: “I take my hat off’ comes from a letter from Henry Hurd to Caroline Latimer, Feb. 2, 1906. “I salute you” comes from Kelly, Walter Reed and Yellow Fever, p. 139. Both these responses, which come from secondary sources, are unlikely to be true. See Pierce and Writer, p. 177, for a discussion.
“gladly accepted”: Moran, “Memoirs of a Human Guinea Pig,” p. 9.
“courage . . . has never been surpassed”: Reed, “The Propagation of Yellow Fever,” p. 98.
14. Testing Times
“I shall regret”: Letter from Walter Reed to George Sternberg, Jan. 31, 1901.
15. More Bugs
weather had somehow affected the mosquitoes: Although cold may affect the amount of time the yellow fever germ has to stay inside a mosquito before that insect can infect another individual, Pierce and Writer have pointed out that some of the early experiments may not have worked because the mosquitoes were not properly-infected. Scientists now know, as the Reed team did not, that an insect must bite a yellow fever victim in the first three days of the illness in order to pick up the germ that causes the disease.
“I felt . . . as though six Ford cars”: Quotation and description of the incident from Kissinger, p. 3.
“It is with a great deal”; “Rejoice with me”: Letter from Walter Reed to his wife, Dec. 9,1900.
“Merry Christmas, Moran”: Moran, Draft fragments: “Walter Reed’s Human Guinea Pigs,” p. 6.
16. Celebration
“with many blushes”: Letter from Walter Reed to his wife, Dec. 26, 1900, in Blossom Reed, p. 21.
“11:50 p.m. Dec 31 ”: Letter from Walter Reed to his wife, Dec. 31, 1900, in Blossom Reed, pp. 22–23.
Someday, Reed hoped: By mentioning that he hoped twentieth-century scientists would find a cure for yellow fever in his Dec. 31, 1900, letter to his wife, Reed makes it clear that he looked forward for further research. Crosby, p. 182, also indicates that Reed was planning to do additional research himself.
Epilogue
“Vaccinations!”: Amarilla, p. A4.
Photo Credits
Unless otherwise noted in the text, all photos have been obtained from the following sources:
Centers for Disease Control and Prevention: [>], [>], [>], [>], [>], [>] (photo by James Gathany), [>].
Historical Collections & Services, Claude Moore Health Sciences Library, University of Virginia: frontispiece (Lazear, Finlay, and Reed), [>], [>], [>], [>], [>], [>], [>], [>], 42, [>], [>], [>], [>], [>], [>], [>], [>], [>], [>], [>], [>], [>].
Library of Congress: [>], [>], [>], [>], [>], [>], [>].
National Library of Medicine: frontispiece (Agramonte and Carroll), [>], [>], [>], [>], [>], [>], [>], [>], [>], [>], [>].
Richard B. Jurmain: [>].
Superior Galleries: [>].
Bibliography
Note: Writing this book would have been impossible without online access to the wonderful Philip S. Hench Walter Reed Yellow Fever Collection at the University of Virginia (http://yellowfever.lb.virginia.edu/reed/collection.html), which includes a rich and searchable array of documents, letters, articles, and photographs. In order to save space, the title of this source has been abbreviated as Hench Coll., University of Virginia, in the entries that follow.
Agramonte, Aristides. “A Statement Regarding the Work Carried Out by the Army Board, August 31, 1908.” Hench Coll., University of Virginia.
——. “The Inside Story of a Great Medical Discovery,” World Wide School Library, Seattle, Washington, 1998 (www.worldwideschool/library/books/tech/medicine/YellowFever/chapl.html; www.worldwideschool.org/library/books/tech/medicine/YellowFever/chap2.html ).
Altman, Lawrence K. Who Goes First: The Story of Self-Experimentation in Medicine. Berkeley: University of California Press, 1998.
Amarilla, Pablo. “Vaccine short, Paraguay in panic over yellow fever,” Los Angeles Times, Feb. 25, 2008, p. A4.
Andrus, John H. “I Become a Guinea Pig: An Episode from Big Moments in a Little Life—A Report.” Hench Coll., University of Virginia.
Anon. “A Hero from the Ranks,” Outlook, June 29, 1907. Hench Coll., University of Virginia.
——. Consent form for Antonio Benigno. Hench Coll., University of Virginia.
——. Log Book of the Yellow Fever Commission’s work. New York Academy of Medicine, Rare Book Collection.
——. “Mosquito Carries Yellow Fever,” New York Times, Oct. 27, 1900. Hench Coll., University of Virginia.
——. Special order #25, Aug. 22, 1900. Hench Coll., University of Virginia.
——. “Student of Yellow Fever,” Chicago Record, 1900. Hench Coll., University of Virginia.
——. “The Mosquito Hypothesis,” Washington Post, Nov. 2, 1900. Hench Coll., University of Virginia.
——. “The Southern Epidemic,” New York Times, Oct. 8, 1878.
——. “Viral hemorrhagic fevers” from MayoClinic.com special to CNN.com (www.cnn.com/HEALTH/library/DS/00539.html).
Bean, William B. Walter Reed: A Biography. Charlottesville: University Press of Virginia, 1982.
Blum, John M., William S. McFeely, Edward S. Morgan, Arthur M. Schlesinger, Jr., Kenneth M. Stampp, and C. Vann Woodward. The National Experience: A History of the United States, 6th ed. San Diego: Harcourt Brace Jovanovich, 1985.
Bruce-Chwatt, L. J. “Malaria” in the Cecil-Loeb Textbook of Medicine, 13th ed., vol. 1, edited by Paul B. Beeson and Walsh McDermott. Philadelphia: W. B. Saunders, 1971.
Carroll, James. Correspondence. Hench Coll., University of Virginia.
——. “Yellow Fever: A Popular Lecture on Yellow Fever” in Yellow Fever: A Compendium of Various Publications: The Results of the Work of Major Walter Reed, Medical Corps, United States Army and the Yellow Fever Commission, 1911. Hench Coll., University of Virginia.
——. “Report to the Surgeon General on Yellow Yellow Fever” in Yellow Fever: A Compendium of Various Publications: Results of the Work of Major Walter Reed, Medical Corps., United States Army and the Yellow Fever Commission, 1911. Hench Coll., University of Virginia.
Crosby, Molly Caldwell. The American Plague: The Untold Story of Yellow Fever, The Epidemic That Shaped Our History. New York: Berkeley Books (Penguin), 2006.
De Kruif, Paul. Microbe Hunters. New York: Pocket Books, 1964.
Dickerson, James L. Yellow Fever: A Deadly Disease Poised to Kill Again. Amherst, N.Y.: Prometheus Books, 2006.
Downs, Wilbur. ‘Yellow Fever” in the Cecil-Loeb Textbook of Medicine, 13th ed., vol. 1, edited by Paul B. Beeson and Walsh McDermott. Philadelphia: W. B. Saunders, 1971.
E.H. Net Economic History Service (eh.net/hmit).
Finlay, Carlos E., Morton C. Kahn, ed. Carlos Finlay and Yellow Fever. New York: Institute of Tropical Medicine of the University of Havana by the Oxford University Press, 1940.
Hemmeter, John C. “Major James Carroll of the United States Army, Yellow Fever Commission, and the Discovery of the Transmission of Yellow Fever by the Bite of the Mosquito ‘Stegomyia Fasciata.’ ” 1908. Hench Coll., University of Virginia.
The Secret of the Yellow Death Page 8
